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Contact Information

MAGNOLIA BEHAVIORAL HEALTH, PLLC
602 E ACADEMY ST STE 205
FUQUAY VARINA, NC27526-2382
 Phone: 919-635-6202
 Fax: 919-289-1713
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prevention Professional

405300000X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for MAGNOLIA BEHAVIORAL HEALTH PLLC · (Female)

NPI Number 1245013770
Status Active
Credentials
Entity Individual
Enumeration date 08/17/2023
Last updated 03/08/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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