| NPI | 1164662888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN R SHERROD Member 252-413-0842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TR0400X Psychologist Rehabilitation |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2009-02-21 |
| Last Update Date | 2009-02-21 |