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Individual

ASHLEY HEATHER BUCKHOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LCAS

Contact information

Practice address
116 HEALTH DR, GREENVILLE, NC 27834-7704
(252) 413-1965
(252) 413-0500
Mailing address
116 HEALTH DR, GREENVILLE, NC 27834-7704
(252) 413-1965
(252) 413-0500

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1885
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6112268
NC
Enumeration date
08/11/2011
Last updated
07/30/2012
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