Individual
MR. BRUCE HUNTER CORREGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
847 W LAKE DR, MOUNT AIRY, NC 27030-2157
(336) 783-6919
(336) 786-6312
Mailing address
137 N SUMMIT DR, MOUNT AIRY, NC 27030-8991
(336) 755-8221
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
472
NC
101YP2500X
Professional Counselor
S2918
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102323
—
NC
Enumeration date
04/23/2007
Last updated
07/31/2013
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