Individual
DESMOND MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4701 FAYETTEVILLE RD, LUMBERTON, NC 28358-2697
(910) 370-0776
Mailing address
1720 LOCKLEAR RD, PEMBROKE, NC 28372-8582
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-24467
NC
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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