| Doctor Name: | CORTNEY PHELON LO |
| NPI Number: | 1083084818 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | A11400 |
| Business Practice Address: | 241 Saint Marys Rd Hillsborough, NC - 272782521 |
| Business Phone Number: | 9192255921 |
| Business Fax Number: | |
| Mailing Address: | 144 E King St, #1582 HILLSBOROUGH |
| State: | NC |
| Postal Code: | 272780107 |
| Phone Number: | 9192255921 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2015 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | A11400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |