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1568940773
FONTASIA MONIQUE WADE-BLIVENS
LEXINGTON, NC
NPI
1568940773
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC P012334)
Enumeration Date
2018-07-31
Last Update Date
2018-07-31
Business Address
FONTASIA MONIQUE WADE-BLIVENS
820 GRIMES BLVD
LEXINGTON, NC 27292-7640
Phone number: 336-224-6071
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Mailing Address
FONTASIA MONIQUE WADE-BLIVENS
350 PEE DEE AVE STE 101
ALBEMARLE, NC 28001-4945
Phone number: 704-986-1500
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