Doctor Name: | MS. AMBER LEA MEDLIN |
NPI Number: | 1003292814 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSWA |
License Number: | P009827 |
Business Practice Address: | 205 Memorial Dr Pinehurst, NC - 28374 |
Business Phone Number: | 9102956853 |
Business Fax Number: | |
Mailing Address: | 284 Executive Park Dr, Suite 100 CONCORD |
State: | NC |
Postal Code: | 280251894 |
Phone Number: | 7049391199 |
Fax Number: | 7049391173 |
NPI Enumeration Date: | 08/04/2015 |
NPI Last Update Date: | 08/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | P009827 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |