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Organization

ADVANCE INTERGRATED MENTORING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SORDAO BERNARD MCKENZIE LCAS-A (THERAPIST)
(336) 404-2110
Entity
Organization

Contact information

Practice address
205 S SKIPPER ST, ROCKINGHAM, NC 28379-3843
(336) 404-2110
Mailing address
205 S SKIPPER ST, ROCKINGHAM, NC 28379-3843
(336) 404-2110

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
2827-A
NC

Other

Enumeration date
05/13/2015
Last updated
05/13/2015
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