| NPI | 1003459348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE WILLIAMS Developmental Therapist 336-906-7350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-10-18 |
| Last Update Date | 2019-10-18 |