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Organization
WILMINGTON HEALTH ACCESS FOR TEENS
Active
Organization
WILMINGTON HEALTH ACCESS FOR TEENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA VAN DE BOVENKAMP CMA (MEDICAL OFFICE ADMINISTRATOR)
(910) 790-9949
Entity
Organization
Contact information
Practice address
4005 OLEANDER DR, WILMINGTON, NC 28403-6816
(910) 790-9949
(910) 790-9455
Mailing address
4005 OLEANDER DR, WILMINGTON, NC 28403-6816
(910) 790-9949
(910) 790-9455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6005437
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005437
—
NC
Enumeration date
02/26/2007
Last updated
08/22/2020
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