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717 Green Valley Rd Ste 222 Greensboro NC 27408-2155 | |
| (336) 544-7679 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 717 Green Valley Rd Ste 222, Greensboro, North Carolina |
| Authorized Official Name and Position | Danielle C Tyler (OWNER/MEMBER) |
| Authorized Official Contact | 3369435312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
717 Green Valley Rd Ste 222 Greensboro NC 27408-2155 Ph: (336) 690-9386 | 717 Green Valley Rd Ste 222 Greensboro NC 27408-2155 Ph: (336) 544-7679 |
| NPI Number | 1730714882 |
|---|---|
| Provider Enumeration Date | 03/10/2020 |
| Last Update Date | 06/25/2021 |
| Certification Date | 06/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730714882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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