NPI | 1619105988 |
---|---|
Entity Type | Organization |
Authorized Contact | THEODUS ROACH Executive Director 704-604-1437 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3676) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C005215) |
1041C0700X Social Worker, Clinical (Licence: NC C006053) | |
1041C0700X Social Worker, Clinical (Licence: NC C005319) | |
1041C0700X Social Worker, Clinical (Licence: NC P002725) | |
Enumeration Date | 2009-06-25 |
Last Update Date | 2009-06-25 |