| NPI | 1659428043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM ELLIS Information Liaison 252-639-7720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |