| NPI | 1043516008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY GREEN Owner/Manager 704-980-9234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 7015A) |
| Enumeration Date | 2011-02-08 |
| Last Update Date | 2011-02-08 |