Provider Demographics
NPI:1760033310
Name:OXENDINE-MYERS, LAURIN
Entity Type:Individual
Prefix:
First Name:LAURIN
Middle Name:
Last Name:OXENDINE-MYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 HORTONS POND RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-5614
Mailing Address - Country:US
Mailing Address - Phone:910-885-8813
Mailing Address - Fax:
Practice Address - Street 1:981 HORTONS POND RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-5614
Practice Address - Country:US
Practice Address - Phone:910-885-8813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health