Individual
DESTINY FAATIMA TIERA BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW-A, LCAS-A
Contact information
Practice address
5856 CORNER OAKS DR, HOPE MILLS, NC 28348-9355
(910) 977-7598
Mailing address
5856 CORNER OAKS DR, HOPE MILLS, NC 28348-9355
(910) 977-7598
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-27727
NC
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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