| Crossvine Clinical Group, Pllc | |
|
140 Wind Chime Ct Ste A Raleigh NC 27615-6580 | |
| (919) 946-3224 | |
| Not Available |
| Full Name | Crossvine Clinical Group, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 140 Wind Chime Ct Ste A, Raleigh, North Carolina |
| Authorized Official Name and Position | Holly Blanc Moses (OWNER) |
| Authorized Official Contact | 9198139415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossvine Clinical Group, Pllc 1109 Whippoorwill Ln Raleigh NC 27609-3643 Ph: (919) 813-9415 | Crossvine Clinical Group, Pllc 140 Wind Chime Ct Ste A Raleigh NC 27615-6580 Ph: (919) 946-3224 |
| NPI Number | 1154090876 |
|---|---|
| Provider Enumeration Date | 09/07/2021 |
| Last Update Date | 09/07/2021 |
| Certification Date | 09/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154090876 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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