| NPI | 1104174796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS SWINDELL ANDREWS Owner 336-268-5519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 251B00000X Case Management | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2015-12-30 |