| NPI | 1578683835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN TILLMAN President 704-510-1535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |