Individual
DIANA WILMA AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
1724 ROXIE AVE, FAYETTEVILLE, NC 28304-1623
(910) 615-3333
Mailing address
1724 ROXIE AVE, FAYETTEVILLE, NC 28304-1623
(910) 615-3333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20054
NC
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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