| NPI | 1558335679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A RUSS President 704-752-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 2886) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2266) |
| 106H00000X Marriage & Family Therapist (Licence: NC 994) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-08-22 |