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Individual

GABRIELLE NATASHA SANDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCAS-A

Contact information

Practice address
326 N SPRING ST, WINSTON SALEM, NC 27101-2722
(336) 631-1948
(336) 631-1948
Mailing address
1401 COVENTRY WOODS CT, GREENSBORO, NC 27405-3769
(336) 501-4065

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-24757
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LCAS-24757
NCSAPPB
NC
Enumeration date
04/09/2019
Last updated
04/09/2019
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