| NPI | 1093171084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA SUPERVILLE Owner 919-271-8579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005337) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-05-09 |