Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 4 | NC |
NPI | 1184750960 |
---|---|
Provider Name | Dr. Lee Stoll Dukes III |
First Address | Lexington, NC 27292-5548 |
Second Address | Lexington, NC 27292-4142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |