Doctor Name: | ALISHA JANIS |
NPI Number: | 1811212335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W. |
License Number: | |
Business Practice Address: | 5228 North Carolina Highway 211 West End, NC - 27376 |
Business Phone Number: | 9106738520 |
Business Fax Number: | |
Mailing Address: | 3460 Woodford Circle Apt 19, FAYETTEVILLE |
State: | NC |
Postal Code: | 28314 |
Phone Number: | 7162075673 |
Fax Number: | |
NPI Enumeration Date: | 03/29/2010 |
NPI Last Update Date: | 03/29/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |