| NPI | 1346324696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY WHITCHARD Owner/Psychologist 251-970-5902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL 1081) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AL 850) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-08-22 |