Healthcare Provider Details

I. General information

NPI: 1427463793
Provider Name (Legal Business Name): EMILY LOCKAMY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 WALNUT ST STE 18
WILMINGTON NC
28401
US

IV. Provider business mailing address

313 WALNUT ST STE 18
WILMINGTON NC
28401-4063
US

V. Phone/Fax

Practice location:
  • Phone: 508-259-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: