| NPI | 1720255680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA SHAWNTAY MCILWAINE Owner/ Therapist 704-340-4666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 6691) |
| Additional Taxonomies | 251S00000X (Licence: NC 1296) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2009-03-28 |