| Doctor Name: | MICHAEL JAMES VANNOY |
| NPI Number: | 1053667725 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | 2086 |
| Business Practice Address: | 789 Poplar Grove Rd S Boone, NC - 286079885 |
| Business Phone Number: | 8287733402 |
| Business Fax Number: | 8665671976 |
| Mailing Address: | 789 Poplar Grove Rd S, BOONE |
| State: | NC |
| Postal Code: | 286079885 |
| Phone Number: | 8287733402 |
| Fax Number: | 8669671976 |
| NPI Enumeration Date: | 07/31/2012 |
| NPI Last Update Date: | 11/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2086 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |