Most Relevant Information
Provider Data
| NPI Number: | 1003548975 |
| Provider Name: | ILLYANA ANTOINESE MASSEY LCSWA |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | P017614 |
Most Important Dates
| Enumeration Date: | 06/28/2022 |
| Last Updated: | 06/28/2022 |
Provider Practice Location
106 FOUNTAIN BROOK CIR STE B
CARY
NC
275114478
Practice Location Phone/Fax
| Phone: | 9803281775 |
| Fax: |
Provider Mailing Location
2814 VANSTORY ST APT 3C
GREENSBORO
NC
274074797
Provider Mailing Phone/Fax
| Phone: | 9803281775 |
| Fax: |