| NPI | 1730697475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIA CHINON BRISCOE Outpatient Therapist 704-466-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 9869) |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2021-04-14 |