| NPI | 1922277417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELENE JOHNSON Executive Director 336-251-1180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 4074) |
| 103K00000X Behavior Analyst (Licence: 1084186) | |
| 103K00000X Behavior Analyst (Licence: 122977) | |
| 103K00000X Behavior Analyst (Licence: 0125034) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2023-06-21 |