Individual
MS. DAVA MUSERALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHCS
Contact information
Practice address
3725 NATIONAL DR STE 220, RALEIGH, NC 27612-4879
(919) 781-8370
(919) 781-2266
Mailing address
3725 NATIONAL DR STE 220, RALEIGH, NC 27612-4879
(919) 781-8370
(919) 781-2266
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4864
NC
101YP2500X
Professional Counselor
Primary
S4864
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142AR
BCBS NC
NC
05
—
6102717
—
NC
Enumeration date
10/24/2006
Last updated
01/13/2022
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