| NPI | 1356757918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REID WHITESIDE Owner 919-677-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: NC 1507) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |