Healthcare Provider Details

I. General information

NPI: 1497217079
Provider Name (Legal Business Name): SUE ASHE BALDWIN ED.D., BCPP,
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 TWAIN RD
GREENSBORO NC
27405-4114
US

IV. Provider business mailing address

1918B WHISPER LAKE DR
WHITSETT NC
27377-9816
US

V. Phone/Fax

Practice location:
  • Phone: 336-662-7408
  • Fax:
Mailing address:
  • Phone: 336-662-7408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: