Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | PROVISIONAL | NC |
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1543 | |
N | 225C00000X | Rehabilitation Counselor | 00100749 | NC |
NPI | 1083947519 |
---|---|
Provider Name | Monica Renee Conner |
First Address | Greenville, NC 27834-7818 |
Second Address | Greenville, NC 27834-7818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2009 |
Last Update Date | 02/03/2015 |