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Individual

TYRONE ELIJAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSWA

Contact information

Practice address
216 STEWART PKWY, WASHINGTON, NC 27889-4972
(252) 946-0585
(252) 946-0580
Mailing address
505 CHELTENHAM DR, GREENVILLE, NC 27834-2534
(252) 917-3720

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24366
NC

Other

Enumeration date
10/13/2014
Last updated
12/18/2019
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