Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 5272 | NC |
NPI | 1013575463 |
---|---|
Provider Name | Dr. Krystal L Meares |
First Address | Durham, NC 27707 |
Second Address | Durham, NC 27707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2019 |
Last Update Date | 19/10/2021 |