| NPI | 1235291170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASHEBA KEY-ALLRED Contract Specialist 919-783-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2017-04-24 |