| NPI | 1114405958 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GWENDOLYN THOMPSON Credentialing 919-615-2371 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801097891) | 
| Enumeration Date | 2018-08-03 | 
| Last Update Date | 2025-01-19 |