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Individual

ANNA MCDONOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPA, LPC

Contact information

Practice address
755 SNOW KING DR, JACKSON, WY 83001-8301
(704) 661-3633
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3354
NC
101YM0800X
Mental Health Counselor
1839
WY
101YM0800X
Mental Health Counselor
8185
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3354
LPA
NC
Enumeration date
04/25/2007
Last updated
09/29/2020
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