| NPI | 1972928919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKIELA WATERS Administration Assistant 336-772-4158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2014-02-27 |
| Last Update Date | 2014-02-27 |