| NPI | 1114201944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA EDWARDS Owner 919-845-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1532) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 1532) |
| 103TF0000X Psychologist, Family (Licence: NC 1532) | |
| 103TS0200X Psychologist, School (Licence: NC 1532) | |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |