| NPI | 1720221419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHON MCQUEEN President 919-761-3225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 650) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103K00000X Behavior Analyst | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2009-04-11 |
| Last Update Date | 2009-04-11 |