| NPI | 1861281115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD EVARISTE Clinical Mental Health Counselor 704-286-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-05-03 |
| Last Update Date | 2025-07-12 |