Organization
YADKIN COUNTY SCHOOLS
Active
Other names
Yadkin County ADVP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI MIKLES VESTAL (ADVP DIRECTOR)
33633675187
Entity
Organization
Contact information
Practice address
3801B RIVER ROAD, BOONVILLE, NC 27011-8341
(336) 367-5187
(336) 367-3062
Mailing address
121 WASHINGTON ST, YADKINVILLE, NC 27055-7725
(336) 367-5187
(336) 367-3062
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
MHL-099-002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408907
—
NC
Enumeration date
01/11/2007
Last updated
08/22/2020
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