| NPI | 1134987100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER COUGHENOUR Owner 910-506-8474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 207Q00000X Family Medicine | |
| 363LX0106X Nurse Practitioner, Occupational Health | |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |