| NPI | 1629447685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON AZEVEDO Clinic Director 919-677-0101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4838) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: NC 4838) |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2015-09-21 |