| NPI | 1235640087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WARD Sole Member 910-977-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007216) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 8734) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-19 |