Healthcare Provider Details

I. General information

NPI: 1821663162
Provider Name (Legal Business Name): ALLISON JANE POINDEXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 US 70 HWY E STE 201
GARNER NC
27529-3982
US

IV. Provider business mailing address

7109 CABERNET FRANC DR
WILLOW SPRING NC
27592-8269
US

V. Phone/Fax

Practice location:
  • Phone: 919-791-5611
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP015182
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: