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Organization
EMINENCE IMAGE, LLC
Active
Organization
EMINENCE IMAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LATASHA M BETHEA MS (CEO/OWNER)
(910) 853-2184
Entity
Organization
Contact information
Practice address
1220 NORTH ST, FAYETTEVILLE, NC 28301-4413
(910) 853-2184
Mailing address
1407 ELMWOOD AVE, COLUMBIA, SC 29201-2109
(910) 853-2184
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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