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General NPI Number Information
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NPI Number | 1528253770
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Entity Type | Organization
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Legal Business Name | CENTER FOR STUDENT SUCCESS
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 324 BLACKWELL ST SUITE 1240
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City | DURHAM
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State | NC
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Zip | 27707
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Country | US
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Telephone | 919-680-8921
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Fax | 919-680-8949
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Provider Business Mailing Address
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Address Line | 324 BLACKWELL ST SUITE 1240
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City | DURHAM
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State | NC
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Zip | 27707
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Country | US
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Telephone | 919-680-8921
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Fax | 919-680-8949
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ELIZABETH BRIERE
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Credential | MD
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Telephone | 919-680-8940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 200300125
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License Number State | NC
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