| NPI | 1205434511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CREED COOPER Clinical Mental Health Counselor 336-970-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |