| NPI | 1558778456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA JORDAN Director 336-907-7308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC LMT1534) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A10678) |
| Enumeration Date | 2014-07-13 |
| Last Update Date | 2015-03-25 |