| Wilmington Health Access For Teens | |
|
4005 Oleander Dr Wilmington NC 28403-6816 | |
| (910) 790-9949 | |
| (910) 790-9455 |
| Full Name | Wilmington Health Access For Teens |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4005 Oleander Dr, Wilmington, North Carolina |
| Authorized Official Name and Position | Maria Van De Bovenkamp (MEDICAL OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 9107909949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilmington Health Access For Teens 4005 Oleander Dr Wilmington NC 28403-6816 Ph: (910) 790-9949 | Wilmington Health Access For Teens 4005 Oleander Dr Wilmington NC 28403-6816 Ph: (910) 790-9949 |
| NPI Number | 1033245709 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033245709 | NPI | - | NPPES |
| 6005437 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6005437 (North Carolina) | Primary |
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