Doctor Name: | VERNETTA LEE ELEAZER |
NPI Number: | 1164812632 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, LCAS, CSI |
License Number: | LCAS-20703 |
Business Practice Address: | 932 Old Us 70 W Black Mountain, NC - 287112547 |
Business Phone Number: | 8286694161 |
Business Fax Number: | 8286694164 |
Mailing Address: | 932 Old Us 70 W, BLACK MOUNTAIN |
State: | NC |
Postal Code: | 287112547 |
Phone Number: | 8286694161 |
Fax Number: | 8286694164 |
NPI Enumeration Date: | 02/04/2015 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LCAS-20703 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |