Organization
INNER SHALOM, PLLC
Active
Organization
INNER SHALOM, PLLC
Active
Other names
Inner Shalom
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA MATA LCMHCA (OWNER, SOLE MEMBER/MANAGER)
(252) 325-4131
Entity
Organization
Contact information
Practice address
1230 MEADOW CREEK CHURCH RD, LOCUST, NC 28097-8525
(252) 325-4131
Mailing address
1230 MEADOW CREEK CHURCH RD, LOCUST, NC 28097-8525
(252) 325-4131
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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