| NPI | 1609066307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G. KRAVETZ President, Member, Shareholder 919-599-0536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 1056) |
| Enumeration Date | 2007-07-29 |
| Last Update Date | 2007-07-29 |