| NPI | 1093764128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN BRENNAN HAINES President 919-285-4594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 3509) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MA 8472) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2008-04-15 |