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General NPI Number Information
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NPI Number | 1134504475
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Entity Type | Individual
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Provider Name | KENDRA LILLEY
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Gender | Female
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 1100 RIDGEFIELD BLVD #190
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City | ASHEVILLE
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State | NC
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Zip | 28806-6209
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Country | US
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Telephone | 828-670-7723
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Fax |
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Provider Business Mailing Address
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Address Line | 30 ALEXANDER RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-8405
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Country | US
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Telephone | 828-243-5492
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A11261
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License Number State | NC
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