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NPI 1376806257

NPI 1376806257 : TIJUANA P ADAMS MS, LPC, NCC : GREENVILLE, NC

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General NPI Number Information
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    NPI Number           |    1376806257
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    Entity Type          |    Individual 
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    Provider Name        |    TIJUANA P ADAMS MS, LPC, NCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/16/2012
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    Last Update Date     |    03/01/2014
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Provider Practice Location Address
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    Address Line         |    3011 S MEMORIAL DR STE 5 
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    City                 |    GREENVILLE
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    State                |    NC
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    Zip                  |    27834-6238
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    Country              |    US
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    Telephone            |    252-364-6007
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    Fax                  |    888-509-1504
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Provider Business Mailing Address
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    Address Line         |    3011 S MEMORIAL DR STE 5 
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    City                 |    GREENVILLE
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    State                |    NC
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    Zip                  |    27834-6238
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    Country              |    US
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    Telephone            |    252-364-6007
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    Fax                  |    888-509-1504
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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       |    8380
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    License Number State |    NC
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