| NPI | 1861926792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN TIREY Office Manager 919-467-0537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NC 2014-01031) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC A12861) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |