Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 23064 | NC |
NPI | 1003361668 |
---|---|
Provider Name | Giovani Burton |
First Address | Greensboro, NC 27401-2993 |
Second Address | Greensboro, NC 27401-2993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2016 |
Last Update Date | 17/03/2018 |