Individual
MICHAEL W NUCKOLLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC, LPC
Contact information
Practice address
3000 BETHESDA PL, SUITE 301, WINSTON SALEM, NC 27103-3331
(336) 745-5087
Mailing address
3000 BETHESDA PL, SUITE 301, WINSTON SALEM, NC 27103-3331
(336) 745-5087
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8354
NC
Other
Enumeration date
04/20/2011
Last updated
09/24/2016
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