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Organization

EAST COVE PSYCHIATRIC SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JOANNA WOLICKI-SHANNON M.D. (CHILD/ADULT PSYCHIATRIST)
(252) 523-2781
Entity
Organization

Contact information

Practice address
2901 N HERRITAGE ST STE C, KINSTON, NC 28501-1581
(252) 523-2781
(252) 523-2779
Mailing address
2901 N HERRITAGE ST STE C, KINSTON, NC 28501-1581
(252) 523-2781
(252) 523-2779

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89137CE
NC
Enumeration date
12/21/2007
Last updated
12/21/2007
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