| NPI | 1184372914 |
|---|---|
| Doing Business As | MILICIA A. TEDDER |
| Entity Type | Organization |
| Authorized Contact | MILICIA TEDDER Lpa 336-569-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2022-03-10 |