Individual
MR. LARRY WAYNE CLUBINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, CSAC
Contact information
Practice address
1329 ROBESON ST, FAYETTEVILLE, NC 28305-5531
(910) 438-0939
Mailing address
911 HAY ST, FAYETTEVILLE, NC 28305-5313
(910) 438-0939
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
INTERN
NC
Other
Enumeration date
05/13/2008
Last updated
01/14/2015
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