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General NPI Number Information
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NPI Number | 1124066121
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Entity Type | Organization
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Legal Business Name | THANKSGIVING ENTERPRISES, LLC
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1130 S CHURCH ST
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City | ASHEBORO
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State | NC
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Zip | 27203-6745
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Country | US
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Telephone | 336-626-0208
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Fax | 336-626-0208
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Provider Business Mailing Address
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Address Line | 532 HICKORY CREEK TRL
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City | ASHEBORO
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State | NC
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Zip | 27205-5001
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Country | US
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Telephone | 336-626-0055
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Fax | 336-626-0208
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. DONALD R. BARTLEY
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Credential | LMFT
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Telephone | 336-626-0055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1038
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License Number State | NC
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