| NPI | 1407063308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNINE I SHOOK Counselor 704-529-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 3399) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 837) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |