| NPI | 1750713194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN PENDER ROCHE Licensed Psychologist 919-228-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: 3845) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NC 3845) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 3845) | |
| 103TC0700X Psychologist, Clinical (Licence: NC 3845) | |
| 103TF0000X Psychologist, Family (Licence: NC 3845) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: NC 3845) | |
| 103TS0200X Psychologist, School (Licence: NC 3845) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2013-08-08 |