| NPI | 1104196617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIUS CRAYTON Owner/Board Member 704-956-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 10518) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2012-01-01 |
| Last Update Date | 2012-01-01 |