Individual
MICHELLE KELLI LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
608 JACKSON ST STE 108, ROANOKE RAPIDS, NC 27870-2600
(252) 541-4175
(252) 541-4245
Mailing address
608 JACKSON ST STE 108, ROANOKE RAPIDS, NC 27870-2600
(252) 541-4175
(252) 541-4245
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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