Individual
DARRYL BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
1706 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
(919) 734-6676
(919) 734-9050
Mailing address
1706 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
(919) 734-6676
(919) 734-9050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
971
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111841
—
NC
Enumeration date
07/11/2006
Last updated
07/08/2007
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