NPI | 1780766485 |
---|---|
Entity Type | Organization |
Authorized Contact | MONTY G. GRUBB Psychologist/President 910-686-4300 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 1529) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: NC 1529) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: NC 1529) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 1529) | |
Enumeration Date | 2006-10-20 |
Last Update Date | 2018-06-21 |