Individual
ANGELA M HAVILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
932 OLD US 70 W, BLACK MOUNTAIN, NC 28711-2547
(828) 669-4161
Mailing address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1399
NC
Other
Enumeration date
08/23/2011
Last updated
08/23/2011
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