| NPI | 1548018120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER S VAN DYKE Sole Proprietor/Owner 828-713-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-05-09 |
| Last Update Date | 2024-05-15 |