Individual
MR. JOHN DAVID MIRACLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS NCC LPC
Contact information
Practice address
182 WEST COURT ST, RUTHERFORDTON, NC 28139
(828) 287-7806
(828) 287-0004
Mailing address
PO BOX 878, RUTHERFORDTON, NC 28139
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3647
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1384E
BCBS
NC
Enumeration date
06/20/2006
Last updated
07/08/2007
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