| NPI | 1174363675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CUMMINGS BRANDENBURG Licensed Psychologist 704-255-4529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-05-31 |
| Last Update Date | 2024-06-14 |