NPI | 1568508745 |
---|---|
Entity Type | Organization |
Authorized Contact | TALESHA SYDNEY Provider Enrollment Specialist 919-256-0824 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YP2500X Counselor, Professional |
103T00000X Psychologist | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2007-01-29 |
Last Update Date | 2010-02-25 |