| NPI | 1598288276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA D EDDY Owner/Administrator/Provider 980-257-6705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9099) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 6134) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |