| Jodi Province Counseling Services Pllc | |
|
714 Carolina Ave Ste A Yadkinville NC 27055-7760 | |
| (336) 818-0733 | |
| (336) 818-0734 |
| Full Name | Jodi Province Counseling Services Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 714 Carolina Ave Ste A, Yadkinville, North Carolina |
| Authorized Official Name and Position | Jodi Tilley Province (OWNER) |
| Authorized Official Contact | 3368180733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jodi Province Counseling Services Pllc 1260 College Ave Ste 1 Wilkesboro NC 28697-2700 Ph: (336) 818-0733 | Jodi Province Counseling Services Pllc 714 Carolina Ave Ste A Yadkinville NC 27055-7760 Ph: (336) 818-0733 |
| NPI Number | 1790249969 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 10/12/2020 |
| Certification Date | 10/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790249969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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