Individual
MS. CALLIE JEAN BODENHAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
110 W WALKER AVE, ASHEBORO, NC 27203-6760
(336) 633-7000
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
27155
NC
Other
Enumeration date
07/05/2022
Last updated
11/27/2022
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