| NPI | 1760417570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITA VANNOSKE Clinic Administrator 919-734-6676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: NC 34D2077478) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-08-31 |