Waterside Therapy Associates, P.L.L.C.
Social Worker, Clinical in Williamston, NC. Organization (NPI-2).
NPI number1528091972
StatusActive
Last updated in NPPESNov 14, 2011
Details
- NPI
- 1528091972
- Entity type
- Organization (NPI-2)
- Legal business name
- Waterside Therapy Associates, P.L.L.C.
- Organization subpart
- No
- Enumeration date
- Jul 9, 2006
- Last updated
- Nov 14, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | C002961 | NC | Yes |
| 101YM0800X | Counselor, Mental Health | 5036 | NC |
Practice location
110 Baltimore StWilliamston, NC 27892-2462
Phone 252-944-6076 · Fax 252-923-0111
Mailing address
110 Baltimore StWilliamston, NC 27892-2462
Phone 252-944-6076 · Fax 252-923-0111
Authorized official
Rita Carol Boyette
Co-Owner
2529446076
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