Individual
MS. EDNA DANIELLE SAMPLE-RAGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS
Contact information
Practice address
209 BARIUM SPRINGS DR, STATESVILLE, NC 28677-8454
(704) 832-2200
Mailing address
PO BOX 1, BARIUM SPRINGS, NC 28010-0001
(704) 832-2200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2654A
NC
Other
Enumeration date
10/14/2012
Last updated
10/11/2019
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