| NPI | 1598089203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO SMALL Designee 919-931-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TH0100X Psychologist, Health Service | |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2010-03-24 |