| NPI | 1578192936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAQUIA MAULTSBY Owner/Practitioner 252-320-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 163W00000X Registered Nurse | |
| 251S00000X Community/Behavioral Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2020-04-09 |