| NPI | 1396131769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REAGAN WEST COURLISS Owner, Provider 919-656-0596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 9023) |
| Enumeration Date | 2015-04-12 |
| Last Update Date | 2023-06-08 |