| NPI | 1245899798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REAVYN N WILLIAMSON Owner 336-317-8776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2019-11-20 |