| NPI | 1528232915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS A DEREPENTIGNY Owner 910-864-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC MHL-047-096) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-10-01 |