| Evergreen Therapeutic, Pllc | |
|
7427 Old Stage Rd N Angier NC 27501-7401 | |
| (919) 561-9663 | |
| Not Available |
| Full Name | Evergreen Therapeutic, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 7427 Old Stage Rd N, Angier, North Carolina |
| Authorized Official Name and Position | Anna Bengtson Broadwell (THERAPIST) |
| Authorized Official Contact | 9195619663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapeutic, Pllc Po Box 37501 Raleigh NC 27627-7501 Ph: (919) 249-8675 | Evergreen Therapeutic, Pllc 7427 Old Stage Rd N Angier NC 27501-7401 Ph: (919) 561-9663 |
| NPI Number | 1346840873 |
|---|---|
| Provider Enumeration Date | 10/26/2020 |
| Last Update Date | 10/26/2020 |
| Certification Date | 10/26/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346840873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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