| NPI | 1831658913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA LEE DIAZ Member/Organizer 910-546-7647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-03-26 |