Graduated: 1986
NPI: 1093778276
Practice Locations (2)
22 OFFICE PARK DR
JACKSONVILLE, NC 285467325
9102194070
PROACTIVE THERAPY OF NORTH CAROLINA INC
2303 WELLINGTON DR SW, SUITE B
WILSON, NC 278938620
2522436818
Source: CMS National Downloadable File, September 2026.