Individual
LISA KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 CYNTHIA PL, RALEIGH, NC 27610-3534
(919) 669-0004
Mailing address
1804 CYNTHIA PL, RALEIGH, NC 27610-3534
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22544-A
NC
Other
Enumeration date
03/28/2016
Last updated
03/13/2017
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