Name *
Phone Number *
Phone Number
Please select the type of therapeutic service you are inquiring about
Please be aware that therapist requesting may not be available, but a therapist suited for your needs will contact you.
Please note the age of your child, if child therapy inquiry
Please Note
Contact through this form is not HIPAA compliant. If you desire to make contact in a more confidential manner, please call the listed phone number.

Phone Fax Email

704-912-4095 (704)943-0512


709 Northeast Drive, Suite 22
Davidson, NC, 28036