Provider Demographics
NPI:1538772918
Name:BILD, JOLINA GAYLE (LCMHCA)
Entity type:Individual
Prefix:
First Name:JOLINA
Middle Name:GAYLE
Last Name:BILD
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 WAYNE MEMORIAL DR STE E
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-2203
Mailing Address - Country:US
Mailing Address - Phone:919-587-0001
Mailing Address - Fax:919-587-0007
Practice Address - Street 1:1503 WAYNE MEMORIAL DR STE E
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2203
Practice Address - Country:US
Practice Address - Phone:919-587-0001
Practice Address - Fax:919-587-0007
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health