| NPI | 1295311595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY BADDOUR President 910-777-9165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-03-18 |