Organization
BANNER CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY DEAN POWELL DMIN (DIRECTOR)
(910) 309-1574
Entity
Organization
Contact information
Practice address
2525 RAEFORD RD, SUITE B, FAYETTEVILLE, NC 28305-5091
(910) 309-1574
Mailing address
2525 RAEFORD RD, SUITE B, FAYETTEVILLE, NC 28305-5091
(910) 309-1574
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3565
NC
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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