| NPI | 1982084307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL MARS HOWERTON Sr VP Network Phys & Hs Cmo 336-716-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2023-11-08 |