| NPI | 1396214193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILKIAM WILSON Therapist 252-312-0516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2018-11-21 |
| Last Update Date | 2018-11-21 |