Individual
MRS. TINA LOCKLEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
1123 LOCKLEAR RD, PEMBROKE, NC 28372-7239
(910) 827-2647
Mailing address
1123 LOCKLEAR ROAD, PEMBROKE, NC 28372
(910) 827-2647
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-27456
NC
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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