| NPI | 1215653142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY ALEXANDER SPITZHOFF Mental Health Counselor 704-796-9037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |