Individual
NGOSA PEPALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8855 ELIZABETH BENNET PL, RALEIGH, NC 27616
(919) 349-1728
Mailing address
4400 B OLD POOLE ROAD, RALEIGH, NC 27610
(919) 349-1728
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-23181
NC
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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