Individual
MISS AVRIL L STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, QP, CSAC-INTERN
Contact information
Practice address
3998 DALTON ST, WINSTON SALEM, NC 27105-3428
(336) 784-9470
Mailing address
PO BOX 30373, WINSTON SALEM, NC 27130-0373
(336) 784-9470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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