NPI | 1316385438 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN MICHELLE GRANTHAM Lpc A 919-394-1637 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: NC A10094) |
Enumeration Date | 2013-06-11 |
Last Update Date | 2013-06-11 |