| NPI | 1942245469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R MARSHALL Clinical Psychologist 336-275-6595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC CO0040) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2020-08-22 |