| NPI | 1700603396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA TILLERY Psychologist 919-885-0810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 251S00000X | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |