Individual
MARY ALICE ELEAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
1 CENTERVIEW DR STE 300, GREENSBORO, NC 27407-3712
(336) 617-0469
Mailing address
2102 SHEPHERD WATCH CT APT A, GREENSBORO, NC 27403-3566
(336) 451-8101
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-20629
NC
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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