| NPI | 1700231255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY FOX Owner 336-358-7854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 251S00000X | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |