Individual
THEA VONDRACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1931 NEW GARDEN RD STE 212, GREENSBORO, NC 27410-2556
(336) 338-2011
Mailing address
2901 KOTCHS GROVE CT, BROWNS SUMMIT, NC 27214-9437
(336) 295-3191
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1326
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103607
—
NC
Enumeration date
06/13/2007
Last updated
06/13/2022
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