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Individual

DR. LARRY LONEL HINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2245 STANTONSBURG RD, GREENVILLE, NC 27834-2868
(252) 258-5920
Mailing address
200 OAK BRANCHES CLOSE, WINTERVILLE, NC 28590-9562
(252) 258-5920

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1468
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03196
BCBS ID NUMBER
NC
01
1468
NC LICENSE NUMBER
NC
05
6000392
NC
Enumeration date
12/27/2006
Last updated
12/11/2013
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