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Individual

DEANDRE JERMAINE MCCOY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3950 FAIRSTED DR APT 618, RALEIGH, NC 27612-4590
(252) 259-6459
Mailing address
3950 FAIRSTED DR APT 618, RALEIGH, NC 27612-4590
(252) 259-6459

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
04/18/2018
Last updated
04/18/2018
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