| Doctor Name: | ETHEL DOLORES WARNER |
| NPI Number: | 1164775961 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCA |
| License Number: | A8841 |
| Business Practice Address: | 118 E Walter St Whiteville, NC - 284724142 |
| Business Phone Number: | 9106402724 |
| Business Fax Number: | 9106403474 |
| Mailing Address: | 3210 Fairhill Dr, RALEIGH |
| State: | NC |
| Postal Code: | 276123215 |
| Phone Number: | 9192560824 |
| Fax Number: | 9192560833 |
| NPI Enumeration Date: | 10/18/2012 |
| NPI Last Update Date: | 10/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | A8841 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |