| NPI | 1134378409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON ALISON HARTMAN WILSON Owner 704-655-2827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |