Individual
CHARLOTTE GINYARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAQP, LCAS-A
Contact information
Practice address
806 BELL FORK RD, JACKSONVILLE, NC 28540-6312
(910) 347-2205
Mailing address
198 BRIDLEWOOD DR, JACKSONVILLE, NC 28540-9101
(910) 526-2183
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-21006
NC
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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