Individual
AILEEN IMANA LASSITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1462 CHERRY ST APT 121, WINSTON SALEM, NC 27105-5888
(336) 695-9188
Mailing address
1462 CHERRY ST APT 121, WINSTON SALEM, NC 27105-5888
(336) 695-9188
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A13646
NC
Other
Enumeration date
03/22/2018
Last updated
05/19/2020
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