| NPI | 1629271242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH ANN RIPPERE LONG Owner 910-232-2743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 679) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NC 679) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NC 679) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 679) | |
| 103TC0700X Psychologist, Clinical (Licence: NC 679) | |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family (Licence: NC 679) | |
| 103TH0004X Psychologist, Health (Licence: NC 679) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 679) | |
| 103TS0200X Psychologist, School (Licence: NC 679) | |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2020-08-22 |