| NPI | 1811255037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENIA VALISHA DAVIS Program Director 919-585-4486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist Prescribing (Medical) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2022-07-21 |