Individual
CHARLESTON HILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 CHAPEL HILL RD, DURHAM, NC 27707-1177
(919) 246-5664
(919) 321-0351
Mailing address
1915 CHAPEL HILL RD, DURHAM, NC 27707-1177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26172
NC
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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