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Individual

CHRISTINA LOUISE FOURNIER-SOUTHERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
571 S ALLEN RD, FLAT ROCK, NC 28731
(828) 692-6178
(828) 692-2365
Mailing address
571 S ALLEN RD, FLAT ROCK, NC 28731-9447
(828) 692-6178
(828) 692-2365

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
C003814
NC
1041C0700X
Clinical Social Worker
Primary
C003814
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C003814
LICENSED CLINICAL SOCIAL WORKER
NC
Enumeration date
11/02/2017
Last updated
08/17/2022
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