| NPI | 1568993277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM MICHELLE PEVERALL Practice Manager 910-251-7789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4276) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |