Individual
MR. JONATHAN DAVID HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
(910) 343-0145
Mailing address
615 SHIPYARD BLVD, WILMINGTON, NC 28412-6431
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23568
NC
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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