| NPI | 1982761250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY GARCIA Qm Coordinator 910-864-0187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2009-05-20 |