Individual
MR. DONTAE ANTUAN DONNELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCA, LCASA
Contact information
Practice address
1451 S ELM EUGENE ST # 3112, GREENSBORO, NC 27406-2200
(336) 844-5322
Mailing address
4425 GRAY WOLF WAY, GREENSBORO, NC 27406-8260
(336) 405-7343
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21953
NC
101YM0800X
Mental Health Counselor
Primary
11737
NC
Other
Enumeration date
08/19/2015
Last updated
11/05/2019
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