Individual
SUSAN VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LCAS-A
Contact information
Practice address
806 BELL FORK RD, JACKSONVILLE, NC 28540-6312
(910) 347-2205
Mailing address
806 BELL FORK RD, JACKSONVILLE, NC 28540-6312
(910) 347-2205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750821229
—
NC
Enumeration date
02/27/2018
Last updated
02/27/2018
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