NPI | 1003088451 |
---|---|
Entity Type | Organization |
Authorized Contact | TALESHA ROLLOCK Provider Enrollment Specialist 919-256-0824 |
Organization Subpart ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2008-03-26 |
Last Update Date | 2008-12-17 |