| NPI | 1518138726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK W. TOBIN President 704-373-0134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 2437) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: NC 2437) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: NC 2437) | |
| 103TF0000X Psychologist Family (Licence: NC 2437) | |
| 103TF0200X Psychologist Forensic (Licence: NC 2437) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: NC 2437) | |
| 103TE1100X Psychologist Exercise & Sports (Licence: NC 2437) | |
| 103T00000X Psychologist (Licence: NC 2437) | |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2016-05-11 |