Individual
DIANE GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
397 3RD AVENUE SW, TAYLORSVILLE, NC 28681
(828) 632-7005
Mailing address
839 WILKESBORO BLVD, LENOIR, NC 28645
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4266
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102556
—
NC
Enumeration date
12/13/2006
Last updated
07/08/2007
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