| NPI | 1053653329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MANDEL Owner/Member 336-409-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3705) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-04-16 |