| NPI | 1356583454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA TERESA WILLIAMS Director 252-758-2065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist Prescribing (Medical) (Licence: NC MHL074155) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NC MHL074155) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC MHL074155) | |
| 103TC0700X Psychologist Clinical (Licence: NC MHL074155) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC MHL074155) | |
| 103TF0000X Psychologist Family (Licence: NC MHL074155) | |
| 251S00000X Community/Behavioral Health (Licence: NC MHL074155) | |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-04-03 |