Individual
ELLIOTT HUMPHRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 N HOWE ST, SOUTHPORT, NC 28461-3426
(336) 346-4386
(743) 208-6507
Mailing address
2207 DELANEY DR STE 206, BURLINGTON, NC 27215-5263
(336) 346-4386
(743) 208-6507
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20914
NC
Other
Enumeration date
11/21/2024
Last updated
12/20/2024
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