| NPI | 1851939904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY RAUCH Organizer, Provider 919-307-9520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |