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Individual

MRS. TELIA YEVETTE VIRGIN

Active
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Individual

MRS. TELIA YEVETTE VIRGIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.C.S.W.

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005273
NC
106H00000X
Marriage & Family Therapist
C005273
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6106668
—
NC
Enumeration date
12/14/2006
Last updated
01/19/2010
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