| NPI | 1013507862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY D'ANDREA CHARLES Organizer/Licensed Therapist 336-793-5718 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-07-02 |