Individual
CHABRE MINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
448 LAKESHORE PKWY, ROCK HILL, SC 29730-4264
(803) 329-3177
Mailing address
1615 WAYBRIDGE LN, APT 3B, CHARLOTTE, NC 28210
(609) 635-0771
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NC
101YM0800X
Mental Health Counselor
Primary
—
NC
Other
Enumeration date
06/25/2014
Last updated
09/12/2019
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