Individual
MACY NESOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
208 E BESSEMER AVE, GREENSBORO, NC 27401-1416
(336) 542-2076
Mailing address
446 BRENT ST, WINSTON SALEM, NC 27103-2753
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A15813
NC
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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