Individual
DELIA VICIDOMINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
311 WILLIAMSON RD STE 103, MOORESVILLE, NC 28117-5967
(704) 360-3049
Mailing address
6155 OLDE FIELDS WAY, PFAFFTOWN, NC 27040-8223
(336) 575-6660
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A16323
NC
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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