| NPI | 1740691203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | S WALLACE Project Director/Licensed Therapist 919-247-9534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C008919) |
| Enumeration Date | 2014-05-17 |
| Last Update Date | 2015-03-13 |