| NPI | 1154475572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTAL ISAIAH Clinical Director 704-506-6204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005180) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |