Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 8040 | NC |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 3028-A | NC |
Y | 101YM0800X | Mental Health Counselor | 8040 | NC |
N | 101YP1600X | Pastoral Counselor | 8040 | NC |
N | 101YP2500X | Professional Counselor | 8040 | NC |
NPI | 1124336987 |
---|---|
Provider Name | Sonya Renee Oglesby |
First Address | Winston Salem, NC 27107-6808 |
Second Address | Winston Salem, NC 27107-6808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2010 |
Last Update Date | 27/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6115116 | (05) | NC |