Healthcare Provider Details

I. General information

NPI: 1215402102
Provider Name (Legal Business Name): HOLLY EUDORA STEELE LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2018
Last Update Date: 10/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 MALLOY ST STE E
GOLDSBORO NC
27534-4478
US

IV. Provider business mailing address

4280 BEN DAIL RD
LA GRANGE NC
28551-8715
US

V. Phone/Fax

Practice location:
  • Phone: 919-778-5594
  • Fax: 919-778-5633
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA14381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: