NPI | 1710032966 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDA FRAZIER Provider Enrollment Specialist 919-256-0824 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2007-01-25 |
Last Update Date | 2007-07-24 |