| NPI | 1700591047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRISSEL M LLOYD Owner 910-476-3992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 103TH0004X Psychologist Health | |
| 103TH0100X Psychologist Health Service | |
| 103TP2701X Psychologist Group Psychotherapy | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-01-20 |