Healthcare Provider Details

I. General information

NPI: 1518493154
Provider Name (Legal Business Name): CATHY TROUBLEFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

238 S MAIN ST
OAKBORO NC
28129-7718
US

IV. Provider business mailing address

238 S MAIN ST
OAKBORO NC
28129-7718
US

V. Phone/Fax

Practice location:
  • Phone: 704-438-6717
  • Fax:
Mailing address:
  • Phone: 704-438-6717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA12914
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: