| NPI | 1275820144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANNE ETHERIDGE President 919-600-4906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3686) |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2020-01-24 |