| NPI | 1659012789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGUERITA SITRIN BLAKER Owner 704-488-4127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-05-17 |