| NPI | 1952834640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACON FUNDERBURK Office Manager 910-790-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-08-21 |