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General NPI Number Information
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NPI Number | 1518323658
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Entity Type | Organization
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Legal Business Name | REHOBOTH COUNSELING SERVICES
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 415 HOLLOMAN AVE E
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City | AHOSKIE
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State | NC
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Zip | 27910-2314
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Country | US
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Telephone | 252-332-8700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57
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City | AHOSKIE
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State | NC
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Zip | 27910-0057
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Country | US
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Telephone | 252-332-8700
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | DR. TAUNYA MARIE QUEEN-MELENDEZ
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Credential | LPC
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Telephone | 252-332-8700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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