| NPI | 1619583408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLEE MARIE MILLER Clinical Psychologist 919-428-5263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |