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Individual

AMIA BRISCOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHCS

Contact information

Practice address
213 PATTON DR STE A, SHELBY, NC 28150-4696
(704) 466-3022
(844) 272-6196
Mailing address
213 PATTON DR STE A, SHELBY, NC 28150-4696
(191) 993-1238
(844) 272-6196

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9869
NC
101YM0800X
Mental Health Counselor
A9869
NC
101YM0800X
Mental Health Counselor
S9869
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1255753281
NC
Enumeration date
01/10/2014
Last updated
04/14/2021
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