Organization
NOCD NORTH CAROLINA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL DURHAM PH.D. (PSYCHOLOGIST)
(828) 424-3773
Entity
Organization
Contact information
Practice address
374 LAKEWIND DR, MONCKS CORNER, SC 29461-7448
(828) 424-3773
Mailing address
225 N MICHIGAN AVE STE 1430, CHICAGO, IL 60601-7653
(312) 569-0820
(312) 261-5080
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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