| NPI | 1851457170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MICHAEL LARTER Clinical Psychologist 336-228-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |