| NPI | 1013701978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CARDEN Authorized Official 336-343-5776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-09-03 |