Individual
CASAUNDRIA PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
436 E LONG AVE, GASTONIA, NC 28054-2516
(704) 853-8227
Mailing address
PO BOX 215, GASTONIA, NC 28053-0215
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6523
NC
101YM0800X
Mental Health Counselor
6523
NC
101YP2500X
Professional Counselor
6523
NC
Other
Enumeration date
03/20/2007
Last updated
09/08/2009
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