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General NPI Number Information
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NPI Number | 1902334832
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Entity Type | Individual
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Provider Name | NICOLE L WATLINGTON LPCA, NCC, MS
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Gender | Female
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 05/23/2017
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Provider Practice Location Address
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Address Line | 403 PARKWAY STE G
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City | GREENSBORO
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State | NC
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Zip | 27401-1653
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Country | US
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Telephone | 336-340-6566
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Fax |
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Provider Business Mailing Address
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Address Line | 7151 W FRIENDLY AVE UNIT G
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City | GREENSBORO
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State | NC
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Zip | 27410-6345
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Country | US
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Telephone | 336-340-6566
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | A11992
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License Number State | NC
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