| NPI | 1154831576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL LEONARD HARRIS Owner / Rendering Provider 910-398-0188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2024-03-13 |