| NPI | 1972170504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIETRIX URQUHART Owner 919-408-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2021-11-30 |