Individual
CHAUNCEY MANIQUE TIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3427 MELROSE RD, FAYETTEVILLE, NC 28304-1608
(910) 864-8739
(910) 864-8222
Mailing address
1410 MINGARY AVE, FAYETTEVILLE, NC 28306-7810
(704) 770-1194
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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