| NPI | 1043725195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARTIN PENNINGTON Therapist, Owner 980-484-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 7597) |
| 101YM0800X Counselor, Mental Health (Licence: NC 8242) | |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2022-09-21 |