| NPI | 1598053399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH J HEADEN Psychiatry 336-584-5255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 9400266) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2011-07-13 |