| NPI | 1477882249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY PRIDGEN CFO 919-734-8803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 102L00000X Psychoanalyst (Licence: NC 2518) |
| 103T00000X Psychologist (Licence: NC 0715) | |
| 1041C0700X Social Worker, Clinical (Licence: NC C005336) | |
| 1041C0700X Social Worker, Clinical (Licence: NC C004079) | |
| 207Q00000X Family Medicine (Licence: NC 34782) | |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2023-09-29 |