Individual
MS. MARY L LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
107 COMMERCE ST STE D, GREENVILLE, NC 27858-5027
(252) 355-2768
(252) 355-0403
Mailing address
107 COMMERCE ST STE D, GREENVILLE, NC 27858-5027
(252) 355-2768
(252) 355-0403
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C001736
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133CM
BCBS NC
NC
05
—
6003563
—
NC
Enumeration date
02/03/2006
Last updated
07/08/2007
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