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Individual

MS. NANCY AUSBON WILLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCAS, CCS

Contact information

Practice address
100 BILLINGSLEY RD, CHARLOTTE, NC 28211-1002
(704) 376-7447
Mailing address
3015 CHINABERRY COURT, MATTHEWS, NC 28104-4314
(704) 882-3491

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
584
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6110517
NC
Enumeration date
06/01/2007
Last updated
07/09/2007
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