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General NPI Number Information
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NPI Number | 1043857386
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Entity Type | Organization
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Legal Business Name | WALK WITH ME
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 4108 LB PROPST DR
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City | CONOVER
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State | NC
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Zip | 28613-8830
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Country | US
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Telephone | 828-302-3431
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Fax |
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Provider Business Mailing Address
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Address Line | 4108 LB PROPST DR
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City | CONOVER
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State | NC
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Zip | 28613-8830
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Country | US
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Telephone | 828-302-3431
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER BANDY
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Credential |
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Telephone | 828-302-3431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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