Individual
MR. HAROLD GINO LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
723 S COX ST, ASHEBORO, NC 27203-6461
(336) 626-9139
(336) 683-8256
Mailing address
723 S COX ST, ASHEBORO, NC 27203-6461
(336) 626-9139
(336) 683-8256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00078
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111760
—
NC
Enumeration date
12/13/2005
Last updated
09/08/2008
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