| NPI | 1902199748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA VATH Office Manager 919-783-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 3757) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: NC 5028) |
| 235Z00000X Speech-Language Pathologist, (Licence: NC 6834) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |