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Organization
SIMPLY TEEN OUTPATIENT
Active
Organization
SIMPLY TEEN OUTPATIENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA MARIE KINNAN MRC, LCMHCS (OWNER/THERAPIST)
(919) 869-5301
Entity
Organization
Contact information
Practice address
800 W WILLIAMS ST STE 203, APEX, NC 27502-5200
(919) 869-5301
(855) 678-6632
Mailing address
800 W WILLIAMS ST STE 203, APEX, NC 27502-5200
(919) 869-5301
(855) 678-6632
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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