Doctor Name: | MRS. DONNA BOLICK LAIL |
NPI Number: | 1033259452 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | C002116 |
Business Practice Address: | 4475 Union Baptist Rd 1120 Taylorsville Rd. Lenoir, NC - 286459284 |
Business Phone Number: | 8287570700 |
Business Fax Number: | 8287570721 |
Mailing Address: | Po Box 338, 204 Idol Drive THOMASVILLE |
State: | NC |
Postal Code: | 273610338 |
Phone Number: | 3364741238 |
Fax Number: | 3364724605 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | C002116 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |