Individual
DEE ANN ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1420A S POLLOCK ST, SELMA, NC 27576-3404
(919) 351-0428
(919) 351-0814
Mailing address
1420A S POLLOCK ST, SELMA, NC 27576-3404
(919) 351-0428
(919) 351-0814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C007177
NC
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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