Organization
DAE LLC
Active
Other names
DAE Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMMANUEL BARNETT (EXECUTIVE DIRECTOR)
(704) 591-2927
Entity
Organization
Contact information
Practice address
113 W FIRETOWER RD, SUITE G, WINTERVILLE, NC 28590-8377
(252) 758-1300
(252) 758-0015
Mailing address
113 WEST FIRE TOWER RD., SUITE G, WINTERVILLE, NC 28590-8377
(252) 758-1300
(252) 758-0015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1021
NC
101YP2500X
Professional Counselor
Primary
5318
NC
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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