Individual
MR. LEON JACKSON PERNELL SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
804 S GARNETT ST, HENDERSON, NC 27536-4571
(252) 430-8774
(252) 430-8821
Mailing address
804 S GARNETT ST, HENDERSON, NC 27536-4571
(252) 430-8774
(252) 430-8821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
56
NC
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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