Individual
DORESSIA MCKETHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1952 SIMON ST, FAYETTEVILLE, NC 28312-5380
(910) 797-7490
Mailing address
1952 SIMON ST, FAYETTEVILLE, NC 28312-5380
(910) 797-7490
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
05/20/2015
Last updated
05/20/2015
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