| NPI | 1437924222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY MICHELE DOUGLAS Licensed Clinical Mental Health Cou 336-313-2668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-11-21 |
| Last Update Date | 2024-04-25 |