| NPI | 1316164775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE WALTERS Administrator 910-794-8892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2564) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |