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Individual

KIMESHA KELLY SPINKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
525 GREENBRIAR FARM TRL, SILER CITY, NC 27344-9284
(336) 302-0801
Mailing address
525 GREENBRIAR FARM TRL, SILER CITY, NC 27344-9284
(336) 302-0801

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
103K00000X
Behavior Analyst
104100000X
Social Worker
171M00000X
Case Manager/Care Coordinator
Primary
172V00000X
Community Health Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21940
LCAS-A
NC
Enumeration date
07/22/2016
Last updated
07/22/2016
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