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Individual

MS. MARY L. DOUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.P.C.A.

Contact information

Practice address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 402-1060
Mailing address
913 N CAROLINA AVE, STATESVILLE, NC 28677-3414
(704) 402-1060

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A8278
NC
101YM0800X
Mental Health Counselor
A8278
NC
101YP1600X
Pastoral Counselor
A8278
NC
101YP2500X
Professional Counselor
A8278
NC

Other

Enumeration date
11/02/2010
Last updated
11/02/2010
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