| NPI | 1134584626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA SPIVEY JOHNSON Executive Director 704-307-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 207R00000X Internal Medicine | |
| 251S00000X | |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2022-03-01 |