Individual
REBECCA MORRISON OTALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
648 E MONMOUTH ST, WINSTON SALEM, NC 27107-3227
(336) 718-4360
(336) 718-4369
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0701005782
VA
101YP2500X
Professional Counselor
Primary
13666
NC
Other
Enumeration date
04/23/2014
Last updated
03/04/2021
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