NPI | 1790219871 |
---|---|
Entity Type | Organization |
Authorized Contact | SAMUEL NDUPU Clinical Director 980-224-8060 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 4936) |
Enumeration Date | 2017-04-17 |
Last Update Date | 2019-09-06 |