Individual
MR. NATHANIEL GAZAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSACI
Contact information
Practice address
631 WILLOW CREEK RD, LEICESTER, NC 28748-5646
(886) 831-9107
Mailing address
631 WILLOW CREEK RD, LEICESTER, NC 28748-5646
(886) 831-9107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/19/2016
Last updated
08/19/2016
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