Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 26781 | NC |
Y | 101YM0800X | Mental Health Counselor | A16360 | NC |
NPI | 1003400201 |
---|---|
Provider Name | Patricia Sunshine Duggan |
First Address | Fayetteville, NC 28314-1073 |
Second Address | Fayetteville, NC 28314-1525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2021 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003400201 | NPI (01) | NC |