Individual
NINA LEA HAYHURST-CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LPA, HSP-PA
Contact information
Practice address
1920 TRADD CT, WILMINGTON, NC 28401-6637
(910) 343-6890
Mailing address
132 PARSLEY LN APT 304, LELAND, NC 28451-9349
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3839
NC
103TC0700X
Clinical Psychologist
Primary
3839
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107635
—
NC
Enumeration date
09/30/2009
Last updated
11/10/2010
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