Doctor Name: | DR. WILLIAM DALE BROTHERTON |
NPI Number: | 1992026462 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 3117 |
Business Practice Address: | 91 Killian Bldg. Lane 204a Killian Bldg. Cullowhee, NC - 28723 |
Business Phone Number: | 8282273284 |
Business Fax Number: | 8282277021 |
Mailing Address: | 91 Killian Bldg. Lane, 204a Killian Bldg. CULLOWHEE |
State: | NC |
Postal Code: | 28723 |
Phone Number: | 8282273284 |
Fax Number: | 8282277021 |
NPI Enumeration Date: | 06/18/2010 |
NPI Last Update Date: | 06/18/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3117 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |