Individual
RONALD MCILWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
5601 EXECUTIVE CENTER DR, CHARLOTTE, NC 28212-8863
(704) 537-1022
(704) 569-0822
Mailing address
1124 WHITE PLAINS RD, CHARLOTTE, NC 28213-5861
(704) 834-9290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29522
NC
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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