| NPI | 1306183546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CHRISTINE CHEPKE Co Owner 704-457-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2009-00088) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C007832) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2017-05-11 |