| NPI | 1407585516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANNE MCCLARY CAC Director 336-342-3331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics Child Abuse Pediatrics |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |