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Individual

ANN DIXON COPPAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
640 HOLLY AVE, WINSTON SALEM, NC 27101-2716
(336) 725-3999
Mailing address
3419 S MAIN ST, WINSTON SALEM, NC 27127-5127
(336) 785-9445

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
521
NC

Other

Enumeration date
07/26/2006
Last updated
07/08/2007
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