| NPI | 1487907762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS CORNELIUS SPELLER Owner 919-225-8016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |