| NPI | 1154725133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEENA H WILLIS Owner 704-281-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |