JONATHAN REVELS

MARION, NC
NPI1932559911
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NC  LCAS-22868)
Enumeration Date2016-06-21
Last Update Date2016-06-21
Business Address
JONATHAN REVELS MS, LCASA
117 W MEDICAL CT
MARION, NC 28752-5590
Phone number: 828-659-3966
Mailing Address
JONATHAN REVELS MS, LCASA
515 CLANTON RD
CHARLOTTE, NC 28217-1309
Phone number: