Individual
DEWAYNE BROADNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9033 LAKE ROYALE, LOUISBURG, NC 27549-7208
(252) 477-0008
Mailing address
400 HANSKA WAY, RALEIGH, NC 27610-2262
(919) 825-8897
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS21099
NC
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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