| NPI | 1558551101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE E. MITCHELL Owner/Manager 252-287-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC 2147) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 2147) |
| 103TC0700X Psychologist, Clinical (Licence: NC 2147) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |