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Individual

MR. COLLINS YEBOA SIAKWAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, LCAS

Contact information

Practice address
2245 STANTONSBURG RD, SUITE O, GREENVILLE, NC 27834-2868
(252) 752-0130
(252) 752-4949
Mailing address
3180 BALLARDS CROSSROADS RD, GREENVILLE, NC 27834-4707
(252) 561-8417
(252) 752-4949

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1065
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143K0
BCBS
NC
05
6111899
NC
Enumeration date
08/31/2006
Last updated
07/08/2007
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