| NPI | 1760862262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKELIN JENNIFER VELOZ JEFFERSON Owner 919-274-4476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 2501) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2015-06-01 |