Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LCASA-25712 | NC |
NPI | 1003577206 |
---|---|
Provider Name | Paula M Scallions |
First Address | Charlotte, NC 28217-1309 |
Second Address | Charlotte, NC 28217-1309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2022 |
Last Update Date | 10/01/2022 |