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General NPI Number Information
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NPI Number | 1275341737
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Entity Type | Individual
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Provider Name | DENESHIA RENE' FERGUSON BS, CADTP, CADC, QP
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 130 WOLFETRAIL RD APT 2H
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City | GREENSBORO
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State | NC
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Zip | 27406-9991
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Country | US
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Telephone | 910-644-7534
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Fax |
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Provider Business Mailing Address
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Address Line | 130 WOLFETRAIL RD APT 2H
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City | GREENSBORO
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State | NC
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Zip | 27406-9991
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Country | US
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Telephone | 910-644-7534
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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 | 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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