| NPI | 1679075824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELVA DOUGLAS Owner 919-633-9403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2018-03-04 |
| Last Update Date | 2018-09-12 |