Individual
SAMANTHEO MARCELLUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 MARTIN LUTHER KING PKWY STE 210, DURHAM, NC 27707-3587
(919) 489-2254
Mailing address
1804 MARTIN LUTHER KING PKWY STE 210, DURHAM, NC 27707-3587
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4657
NC
101YP2500X
Professional Counselor
Primary
4657
NC
Other
Enumeration date
06/22/2009
Last updated
06/22/2009
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