Individual
WILLIAM WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
111 LAMON ST, SUITE 103, FAYETTEVILLE, NC 28301-4901
(910) 261-0941
Mailing address
722 SAGE ST, FAYETTEVILLE, NC 28312-6014
(910) 261-0941
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-22813
NC
Other
Enumeration date
10/12/2016
Last updated
10/12/2016
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