| NPI | 1629356720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LORAINE KELTY Office Manager 910-276-7011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2025-02-03 |