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General NPI Number Information
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NPI Number | 1306033998
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Entity Type | Individual
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Provider Name | CORINNA S. MCMILLON LPC
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Gender | Female
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 02/11/2009
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Provider Practice Location Address
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Address Line | 2014 HOPE MILLS RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4225
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Country | US
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Telephone | 910-425-6136
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Fax |
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Provider Business Mailing Address
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Address Line | 4323 DOMINIQUE ST
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City | HOPE MILLS
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State | NC
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Zip | 28348-2854
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Country | US
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Telephone | 910-322-1479
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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