| NPI | 1609890268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK E. COLE Mgr, Operations & Development 336-896-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ND 3057) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2015-11-05 |