NPI | 1821742552 |
---|---|
Doing Business As | REBELLIOUS THERAPY |
Entity Type | Organization |
Authorized Contact | KATHERINE LEE ELIZABETH WALDRON CEO 704-290-9780 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-02-10 |
Last Update Date | 2022-03-15 |