Individual
MR. CLINTON JAMIE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, M.ED, LCAS, CSI
Contact information
Practice address
1151 W LEBANON ST STE 200, MOUNT AIRY, NC 27030-2225
(276) 728-6703
Mailing address
6776 SNAKE CREEK RD, HILLSVILLE, VA 24343-4586
(276) 728-6703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-2133
NC
Other
Enumeration date
05/07/2019
Last updated
03/07/2022
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