Healthcare Provider Details

I. General information

NPI: 1164604286
Provider Name (Legal Business Name): GUILFORD COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S CENTENNIAL ST
HIGH POINT NC
27260-5215
US

IV. Provider business mailing address

232 N EDGEWORTH ST
GREENSBORO NC
27401-2218
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-7946
  • Fax:
Mailing address:
  • Phone: 336-641-4981
  • Fax: 336-641-7761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: GLENNA HARFORD
Title or Position: BUSINESS MANAGER
Credential:
Phone: 336-641-6920