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Behavioral Health & Social Service Providers Counselor Pastoral

Provider NPI: 1588064398

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
301 S THIRD ST  MEBANE, NC 27302-2617 US
Tel: 336-269-0818  Fax: --

Business Mailing Address:
1003 STUART DR  MEBANE, NC 27302-7111 US
Tel: 336-269-0818  Fax: --

NPI Information:
NPI: 1588064398
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP1600XBehavioral Health & Social Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 101YP1600X





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