| Passion 4 Kids, Llc | |
|
1076 Hawthorn Ln Grayson GA 30017-4208 | |
| (678) 492-9332 | |
| Not Available |
| Full Name | Passion 4 Kids, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1076 Hawthorn Ln, Grayson, Georgia |
| Authorized Official Name and Position | Cassondra Jackson (MENTAL HEALTH CLINICIAN) |
| Authorized Official Contact | 6784929332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passion 4 Kids, Llc 1076 Hawthorn Ln Grayson GA 30017-4208 Ph: (678) 492-9332 | Passion 4 Kids, Llc 1076 Hawthorn Ln Grayson GA 30017-4208 Ph: (678) 492-9332 |
| NPI Number | 1689067878 |
|---|---|
| Provider Enumeration Date | 03/11/2015 |
| Last Update Date | 03/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689067878 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | APC004749 (Georgia) | Primary |
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