Individual
EDEN AMIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
1650 GREENFIELD ST, WILMINGTON, NC 28401-6456
(910) 798-6619
Mailing address
1650 GREENFIELD ST, WILMINGTON, NC 28401-6456
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P016218
NC
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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