| NPI | 1518461839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET ROSE LOLLEY Licensed Professional Counselor 251-654-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: AL 3863) |
| Additional Taxonomies | 261QM0801X (Licence: AL 3863) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |