Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCAS20332 | NC |
NPI | 1003350661 |
---|---|
Provider Name | Dixie J Brown |
First Address | Biltmore Lake, NC 28715-8974 |
Second Address | Biltmore Lake, NC 28715-8974 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2016 |
Last Update Date | 15/12/2016 |