Individual
MILDRED GORDON MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, NCC
Contact information
Practice address
1407 HILLSBOROUGH ST, RALEIGH, NC 27605-1828
(919) 624-1150
Mailing address
1027 VANCE ST, RALEIGH, NC 27608-2259
(919) 828-1858
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5186
NC
Other
Enumeration date
11/03/2008
Last updated
10/18/2012
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