| NPI | 1619613536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMONIKA HARVEY Billing Director 336-273-2640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |