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General NPI Number Information
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NPI Number | 1992480982
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Entity Type | Organization
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Legal Business Name | CHANGING INSIGHT II, LLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 7973 HIGHWAY 90
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City | LONGS
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State | SC
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Zip | 29568-6201
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Country | US
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Telephone | 336-280-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 219 MARSHALL GRAVES RD
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8797
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Country | US
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Telephone | 336-280-9432
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Fax |
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Authorized Official
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Title or Position | EX DIRECTOR
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Name | SHATANYA LASHAWN WALKER
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Credential |
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Telephone | 336-280-9432
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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 |
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License Number State |
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