Provider Information for 1962675777
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Mrs. COURTNEY LYNN SURIGAO MA
Sex: Female
NPI: 1962675777
Last Updated: 2025-02-19
Certification Date: 2025-02-06
Certification Date: 2025-02-06
Details
| Name | Value | ||||||||
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| NPI | 1962675777 | ||||||||
| Enumeration Date | 2008-04-12 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 112 NORTHBROOK DR WILMINGTON, NC 28405-8473 United States Phone: 109-523-2873 | Fax: | ||||||||
| Primary Practice Address | 110 N CORCORAN ST DURHAM, NC 27701-5015 United States Phone: 323-205-7088 | Fax:910-799-3313 | ||||||||
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