Provider Demographics
NPI:1780905570
Name:D'ANTUONO, AUDREY HOWELL (LPC)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:HOWELL
Last Name:D'ANTUONO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 WALTER CHAMBERS ST
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-3421
Mailing Address - Country:US
Mailing Address - Phone:336-432-7772
Mailing Address - Fax:
Practice Address - Street 1:345 WALTER CHAMBERS ST
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-3421
Practice Address - Country:US
Practice Address - Phone:336-432-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7930101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional