| NPI | 1548582596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN B AVERY Administrative Assistant 252-752-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2646) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NC 2646) |
| 103G00000X Clinical Neuropsychologist (Licence: NC 1188) | |
| 103TC0700X Psychologist, Clinical (Licence: NC 1188) | |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |