| NPI | 1891150413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY LYNN SMYTH-DENT Mental Health Clinician 336-337-9864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO NLC.0105303) |
| Enumeration Date | 2015-12-24 |
| Last Update Date | 2015-12-24 |