Individual
CHRISTINA BAZEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 MARTIN LUTHER KING PKWY STE 109, DURHAM, NC 27707-3587
(919) 747-9172
Mailing address
6920 SPANGLERS SPRING WAY, RALEIGH, NC 27610-6180
(919) 282-4190
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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