Individual
SAMANTHA PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
6112 SAINT GILES ST, RALEIGH, NC 27612-7043
(919) 893-4465
Mailing address
212 PROVIDENCE GLEN DR, CHAPEL HILL, NC 27514-6992
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-28291
NC
Other
Enumeration date
07/11/2022
Last updated
07/11/2022
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