| NPI | 1952032898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAZHEDATEQUILA EUNICETAGE SANFORD Owner 704-898-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2022-07-06 |