| NPI | 1275958399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW STEPHEN BURGESS LEARY Licensed Psychologist And Owner 704-776-5584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3953) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 3953) |
| 103TF0000X Psychologist, Family (Licence: NC 3953) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |