| NPI | 1427081793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC L DEITCHMAN Owner 704-364-0452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 892) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 0892) |
| 103T00000X Psychologist (Licence: NC 892) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2011-12-01 |