| NPI | 1881201630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEWEL CHICKERING Billing/Credentialing 704-309-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2024-03-20 |