| NPI | 1629197538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN SHELTON ROGERS Adminstrative Assistant 704-933-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 4478) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 0324) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |