Individual
MRS. KEISHA MOORE SPELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
216 STEWART PKWY, WASHINGTON, NC 27889
(252) 946-0585
(252) 946-0580
Mailing address
111 CHERRY ST, WILLIAMSTON, NC 27892-1903
(252) 508-5237
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3291
NC
101YM0800X
Mental Health Counselor
10072
NC
101YP2500X
Professional Counselor
Primary
10072
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10072
LPC
NC
05
—
10072
—
NC
Enumeration date
03/13/2013
Last updated
06/28/2018
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