| NPI | 1720262678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA CUPP President 704-455-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 3106) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2009-02-09 |