| NPI | 1609391234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE OZETTA TROXLER Owner 336-324-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2790) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |