Organization
ASA THERAPEUTIC SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARMAINE DOWDELL (EXECUTIVE MANAGER)
(910) 938-1300
Entity
Organization
Contact information
Practice address
200 VALENCIA DR STE 128, JACKSONVILLE, NC 28546-6313
(910) 938-1300
(910) 938-2900
Mailing address
200 VALENCIA DR STE 128, JACKSONVILLE, NC 28546-6313
(910) 938-1300
(910) 938-2900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
09/13/2011
Last updated
09/13/2011
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