| NPI | 1144571639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA FERGUSON Licensed Psychologist 910-444-1837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NC 3945) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2018-06-22 |