| NPI | 1336251503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LYN MOORE Licensed Clinical Social Worker 919-787-5897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: NC C004845) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |