| NPI | 1922035260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON VAN WEY Treasurer 919-286-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2019-07-11 |