| NPI | 1104057488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA P GANTT Consultant 910-822-4071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |