Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 3104 | NC |
NPI | 1659674927 |
---|---|
Provider Name | Dr. Vivian Barnette |
First Address | Greensboro, NC 27411 |
Second Address | Greensboro, NC 27411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2010 |
Last Update Date | 08/12/2010 |