| NPI | 1053868521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHANNA FIELDS Owner/ Operator 919-928-2297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 225XM0800X Occupational Therapist, Mental Health |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-10-06 |