Individual
DUSTIN LUKE GANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
229 TURNER DR, REIDSVILLE, NC 27320-5736
(336) 349-2233
Mailing address
229 TURNER DR, REIDSVILLE, NC 27320-5736
(336) 349-2233
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A14119
NC
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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