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Individual

NATHAN DURANT BLANTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCAS

Contact information

Practice address
402 N PINE ST, SUITE C, LUMBERTON, NC 28358-5563
(910) 739-1666
(910) 739-6822
Mailing address
60 COMMERCE PLZ, PEMBROKE, NC 28372-7386
(910) 521-2900
(910) 775-9165

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1844
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1844
NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
NC
Enumeration date
09/02/2011
Last updated
09/02/2011
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