| NPI | 1235685405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA MICHELLE BETHEA Owner 910-853-2184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251S00000X | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |