Individual
DOUGLAS EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC 24173
Contact information
Practice address
118 DOUGLAS ST, FAYETTEVILLE, NC 28312-5310
(910) 682-8872
Mailing address
118 DOUGLAS ST, FAYETTEVILLE, NC 28312-5310
(910) 682-8872
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24173
NC
Other
Enumeration date
04/20/2019
Last updated
04/20/2019
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