| NPI | 1841461944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE H PETRUK Director/Child & Family Therapist 704-604-8023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 4290) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2013-03-14 |