| NPI | 1942320312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARSHIA DONNELL Practice Manager 336-301-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9700286) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2023-12-05 |