Individual
MR. ROBERT S PENNELLO SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHCS
Contact information
Practice address
136 WAXHAW PKWY STE E110, WAXHAW, NC 28173-5029
(919) 522-1559
Mailing address
136 WAXHAW PKWY STE E110, WAXHAW, NC 28173-5029
(919) 522-1559
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
S8956
NC
Other
Enumeration date
10/10/2012
Last updated
10/01/2020
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