| NPI | 1306613880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA MARIE STEELMAN Secretary 704-506-6267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2023-12-05 |
| Last Update Date | 2025-08-01 |