Southlake Center for Self Discovery
NPI #1366656910 in Davidson, North Carolina
Provider Information
- NPI Number
- 1366656910
- Entity Type
- Organization
- Organization Name
- Southlake Center for Self Discovery
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- May 10, 2007
- Last Updated
- Jun 23, 2009
Practice Location
- Address
- 903 NORTHEAST DR STE 201
- City
- Davidson
- State
- North Carolina
- ZIP Code
- 28036-7438
- Phone
- (704) 896-7776
Authorized Official
- Name
- MS. KIMBERLY KRUEGER, MSW, LCSW
- Title
- OWNER DIRECTOR
- Phone
- (704) 896-7776
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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