| NPI | 1336286558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN MUMPER General Manager 910-484-4776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 1875) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 1877) |
| 1041C0700X Social Worker Clinical (Licence: NC C003490) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 95-01354) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2008-01-11 |