Individual
MR. WILLARD WISHARD BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA PSYCHOLOGY
Contact information
Practice address
339 TRIPLE CREEK DR, EFLAND, NC 27243-9573
(919) 304-5670
Mailing address
339 TRIPLE CREEK DR, EFLAND, NC 27243-9573
(919) 304-5670
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111989
—
NC
Enumeration date
03/16/2007
Last updated
01/09/2009
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