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Organization subpart
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Provider details

NPI number
Authorized official
DEBRA ROGERS (CASE MANAGER)
(540) 416-9235
Entity
Organization

Contact information

Practice address
1710 MICHIGAN CIR, LUMBERTON, NC 28358-7129
(540) 416-9235
Mailing address
1710 MICHIGAN CIR, LUMBERTON, NC 28358-7129
(540) 416-9235

Taxonomy

Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
PGP-0640442
VA

Other

Enumeration date
05/06/2014
Last updated
05/06/2014
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