| NPI | 1255635082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL RAMEY Vice President 336-970-1174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NC PC10377) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 7895) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 5902401) | |
| Enumeration Date | 2011-01-09 |
| Last Update Date | 2011-01-22 |