| NPI | 1891865218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACON FUNDERBURK Office Manager 910-790-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 2805) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: NC LPC6828) |
| 1041C0700X Social Worker Clinical (Licence: NC C006434) | |
| 133V00000X Dietitian, Registered (Licence: NC L003399) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-08-21 |