| NPI | 1104186527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC D TUCKER Licensed Therapist 980-285-7236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC c006637) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |