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Organization

CHRYSALIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KANDACE KOONTZ PERRYMAN LPC, NCC, NCSC (OWNER, PSYCHOTHERAPIST)
(336) 885-2116
Entity
Organization

Contact information

Practice address
1312 HAMILTON PL, SUITE 105, HIGH POINT, NC 27265
(336) 885-2116
Mailing address
1312 HAMILTON PL, SUITE 105, HIGH POINT, NC 27265
(336) 885-2116

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4873
NC

Other

Enumeration date
09/08/2009
Last updated
09/08/2009
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