| NPI | 1558755025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA WILLIAMS Clinician 855-377-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 780) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-24 |