| NPI | 1609268655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY MASIELLO Psychologist 704-443-8148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A10291) |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2015-02-27 |