| NPI | 1235709692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIAN ANTIONETTE GIBSON-FORD Owner 919-867-0360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |