Doctor Name: | ROSE ANN MOREDOCK |
NPI Number: | 1437430394 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 8714 |
Business Practice Address: | 162 Schmidt Ln Lumber Bridge, NC - 283579030 |
Business Phone Number: | 9109162244 |
Business Fax Number: | |
Mailing Address: | 2909 Brookberry Ct, FAYETTEVILLE |
State: | NC |
Postal Code: | 283068962 |
Phone Number: | 8136008172 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2011 |
NPI Last Update Date: | 05/15/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 8714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |