| NPI | 1265403042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CLARK Clinic Administrator 919-933-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103T00000X Psychologist | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-02-23 |