| NPI | 1952855413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY GRAVES Owner 336-355-6206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 3531) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2024-09-10 |