Female

Autumn Vaca LMFTA

Marriage & Family Therapist in North Wilkesboro, NC(View on Map)

Full Name

Autumn Vaca LMFTA

NPI Number

1306307806

NPI Type

Individual Provider

Gender

Female

Enumeration Date

03/27/2019

Specialties

(Taxonomies)

Code

106H00000X

Primary Taxonomy

Yes

Licenses

State

North Carolina

License Number

12139A

Contact
Information

Purpose

Mailing
Location

Address

284 EXECUTIVE PARK DR STE 100
1400 WILLOW LN

City

Concord
North Wilkesboro

State

NC
NC

Postal Code

28025-1833
28659-3551

Country

US
US

Telephone Number

(704) 939-1100
(336) 667-5151

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/22/2019

Provider Address

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