Individual
MR. HAROLD O MALLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, CSAC
Contact information
Practice address
111 SUNNYBROOK RD, RALEIGH, NC 27610-1827
(919) 747-0623
(919) 747-0634
Mailing address
111 SUNNYBROOK RD, RALEIGH, NC 27610
(919) 747-0623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2652
NC
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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