Organization · NPI-2

Asa Therapeutic Services, PLLC

Psychologist · Jacksonville, NC

NPI number1366724569
StatusActive
Last updated in NPPESSep 13, 2011

Details

NPI
1366724569
Entity type
Organization (NPI-2)
Legal business name
Asa Therapeutic Services, PLLC
Organization subpart
No
Enumeration date
Sep 13, 2011
Last updated
Sep 13, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X Psychologist––Yes

Practice location

200 Valencia Dr Ste 128
Jacksonville, NC 28546-6313

Phone 910-938-1300 · Fax 910-938-2900

Mailing address

200 Valencia Dr Ste 128
Jacksonville, NC 28546-6313

Phone 910-938-1300 · Fax 910-938-2900

Authorized official

Charmaine Dowdell
Executive Manager
9109381300

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