Individual
NATHANIA TIECORIA ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
309 CRUTCHFIELD ST, DURHAM, NC 27704-2754
(919) 560-7305
(919) 479-0646
Mailing address
309 CRUTCHFIELD ST, DURHAM, NC 27704-2754
(919) 560-7305
(919) 479-0646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3236
NC
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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