| NPI | 1306196944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DAWN PHILLIPS Owner 919-617-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 8809) |
| 1041C0700X Social Worker, Clinical (Licence: NC C007721) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-10-18 |