| NPI | 1679802631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA B POUGH Executive Director 704-531-5656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |