Individual
TIA CAPEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
636 DIXON AVE, ASHEBORO, NC 27203-5352
(910) 975-4280
Mailing address
PO BOX 4664, ASHEBORO, NC 27204-4664
(910) 975-4280
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013459445
—
NC
Enumeration date
11/16/2016
Last updated
11/30/2016
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