Individual
FADZAI MAKONYONGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 CAPITOLA DR, DURHAM, NC 27713-4496
(919) 474-6400
(919) 474-6401
Mailing address
100 CAPITOLA DRIVE, DURHAM, NC 27713
(919) 474-6400
(919) 474-6401
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58-1716970
—
NC
Enumeration date
10/26/2012
Last updated
10/26/2012
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