| NPI | 1184962730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA MCCAIN Sole/Mbr 704-433-5267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NC C005932) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC C005932) |
| 1041C0700X Social Worker, Clinical (Licence: NC C005932) | |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |