| NPI | 1972020907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNTAL ISAIAH Co Owner 704-965-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |