| NPI | 1194911883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SCOTT BENNETT Clinical Psychologist 910-343-1474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2177) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2008-02-12 |