Organization
NEW LEGACY COUNSELING AND TRAINING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TY WATSON SR. LPC (EXECUTIVE DIRECTOR)
(404) 889-2300
Entity
Organization
Contact information
Practice address
3350 RIVERWOOD PARKWAY, SUITE 1925, ATLANTA, GA 30339
(770) 984-5341
(404) 549-4310
Mailing address
3350 RIVERWOOD PARKWAY, SUITE 1925, ATLANTA, GA 30339
(770) 984-5341
(404) 549-4310
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
005753
GA
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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