| NPI | 1770901407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPFON TEONTA PORTLOCK Clinical Director 704-780-9628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C008189) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2014-03-31 |