Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | A8465 | NC |
NPI | 1003239575 |
---|---|
Provider Name | Kristina Mills-Gregory |
First Address | Goldsboro, NC 27530-8936 |
Second Address | Elizabeth City, NC 27909-4510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2014 |
Last Update Date | 09/10/2019 |