| NPI | 1669881645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUISE ROYAL THOMAS Owner 919-822-2172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TH0004X Psychologist, Health | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2014-08-11 |