Individual
TERESA LYNN VACCARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.C.A.S.
Contact information
Practice address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 939-1100
(704) 939-1173
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
631
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111787
—
NC
Enumeration date
09/07/2006
Last updated
07/08/2007
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