Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | A10904 | NC |
NPI | 1003265612 |
---|---|
Provider Name | James Treires |
First Address | Raleigh, NC 27612-6312 |
Second Address | Raleigh, NC 27612-6312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2016 |
Last Update Date | 06/06/2016 |