Individual
MS. ELISA ANGELYN FANLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MA, LCMHC, LCAS
Contact information
Practice address
364 RALEIGH ST, HOLLY SPRINGS, NC 27540-9047
(919) 647-4600
Mailing address
364 RALEIGH ST, HOLLY SPRINGS, NC 27540-9047
(919) 647-4600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2423
NC
Other
Enumeration date
08/25/2010
Last updated
09/23/2025
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