| NPI | 1891403754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEAGAN BULLOCK Owner/Manager 704-831-1999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2022-11-09 |