| NPI | 1265936108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA UMBACH KETTLING Co Owner/Licensed Psychologist 704-910-8381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2019-08-06 |