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Individual

MR. CHARLIE CLEMONS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCAS-A

Contact information

Practice address
709 E MARKET ST STE 100B, GREENSBORO, NC 27401-3282
(336) 378-0109
Mailing address
181 VIRGINIA AVE, DANVILLE, VA 24541-3761
(336) 259-0272

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20133
NC

Other

Enumeration date
10/19/2016
Last updated
10/19/2016
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