NPI | 1861763534 |
---|---|
Entity Type | Organization |
Authorized Contact | LATASHA REGENIA ROGERS Np/CEO 704-966-7710 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC 5003950) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5003950) |
Enumeration Date | 2012-01-26 |
Last Update Date | 2023-03-17 |