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General NPI Number Information
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NPI Number | 1992869267
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Entity Type | Organization
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Legal Business Name | TRIANGLE FAMILY THERAPY
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5500 MCNEELY DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27612-7623
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Country | US
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Telephone | 919-789-4673
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Fax | 919-789-8207
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Provider Business Mailing Address
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Address Line | 5500 MCNEELY DR SUITE 101
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City | RALEIGH
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State | NC
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Zip | 27612-7623
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Country | US
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Telephone | 919-789-4673
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Fax | 919-789-8207
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. REBECCA HOPE DNISTRAN
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Credential | MA
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Telephone | 919-789-4673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 695
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License Number State | NC
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