| NPI | 1972002004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN ROY LEVINE Managing Director 919-264-3755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 650) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2018-02-05 |