Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1964 | NC |
NPI | 1003172487 |
---|---|
Provider Name | Susan L Dowd |
First Address | Raleigh, NC 27613-7096 |
Second Address | Raleigh, NC 27613-7584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2012 |
Last Update Date | 10/04/2012 |