| NPI | 1669977732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LEPAGE Practice Owner 919-572-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2018-03-29 |