Individual
SUSAN LYNNE MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,LCAS,CRC-MAC
Contact information
Practice address
1931 UNION CROSS RD, WINSTON SALEM, NC 27107-6448
(336) 784-9470
(336) 784-9505
Mailing address
1931 UNION CROSS RD, WINSTON SALEM, NC 27107-6448
(336) 784-9470
(336) 784-9505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
07/09/2012
Last updated
07/09/2012
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