| NPI | 1417390444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMMY FAWZY BANAWAN President 919-627-8675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-09 |