Individual
MRS. MARY SIMMONS KINDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA; PLPC; PLCAS; ABD
Contact information
Practice address
1500 BRAGG BLVD, FAYETTEVILLE, NC 28301-4889
(910) 484-1500
(910) 223-1505
Mailing address
2469 CULBRETH RD, EASTOVER, NC 28312-7578
(910) 740-4736
(910) 223-1505
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PROVISIONAL
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
PROVISIONAL
NC
Other
Enumeration date
02/18/2009
Last updated
02/18/2009
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