Individual
LISA MICHELLE KORNEGAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
877 E GANNON AVE STE 103, ZEBULON, NC 27597-9445
(314) 496-2568
(919) 832-0825
Mailing address
877 E GANNON AVE STE 103, ZEBULON, NC 27597-9445
(314) 496-2568
(919) 832-0825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1921
NC
Other
Enumeration date
04/30/2012
Last updated
08/04/2020
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