| NPI | 1518613264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONIQUE KATRESS MCCLINNAHAN Owner And Clinician 910-797-1491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-03-04 |