| NPI | 1508134958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA QUINN Manager 919-818-3182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 1696) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NC 1696) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 1696) | |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2017-04-07 |