Crossvine Clinical Group, PLLC
Counselor, Professional in Raleigh, NC. Organization (NPI-2).
NPI number1154090876
StatusActive
Last updated in NPPESSep 7, 2021
Details
- NPI
- 1154090876
- Entity type
- Organization (NPI-2)
- Legal business name
- Crossvine Clinical Group, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 7, 2021
- Certification date
- Sep 7, 2021
- Last updated
- Sep 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
140 Wind Chime Ct Ste ARaleigh, NC 27615-6580
Phone 919-946-3224
Mailing address
1109 Whippoorwill LnRaleigh, NC 27609-3643
Phone 919-813-9415
Authorized official
Holly Blanc Moses
Owner
9198139415
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