| NPI | 1134077076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA LORAINE BLANCO Licensed Clinical Social Worker 910-580-0594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-03-17 |
| Last Update Date | 2026-03-17 |