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General NPI Number Information
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NPI Number | 1285803668
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Entity Type | Organization
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Legal Business Name | DEBRA MINOR-SCHORK LLC
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Dates
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Enumeration Date | 02/29/2008
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 504 EAST ELIZABETH STREET SUITE 8
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City | ELIZABETH CITY
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State | NC
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Zip | 27909-4404
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Country | US
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Telephone | 252-526-8833
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Fax | 252-482-7462
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Provider Business Mailing Address
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Address Line | 119 MONTPELIER DRIVE
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City | EDENTON
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State | NC
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Zip | 27932-8909
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Country | US
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Telephone | 125-263-2406
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Fax | 252-482-5713
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Authorized Official
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Title or Position | CLINICAL NURSE SPECIALIST
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Name | MRS. DEBRA LYNNE MINOR-SCHORK
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Credential | RN MSN CS
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Telephone | 252-632-4063
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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 | 100093
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License Number State | NC
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