| Bare Ones Soul | |
|
15411 Tuxford Dr Huntersville NC 28078-3713 | |
| (704) 813-4033 | |
| Not Available |
| Full Name | Bare Ones Soul |
|---|---|
| Speciality | Psychologist |
| Location | 15411 Tuxford Dr, Huntersville, North Carolina |
| Authorized Official Name and Position | Bernard Sullivan (OWNER) |
| Authorized Official Contact | 7048134033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bare Ones Soul 15411 Tuxford Dr Huntersville NC 28078-3713 Ph: (704) 813-4033 | Bare Ones Soul 15411 Tuxford Dr Huntersville NC 28078-3713 Ph: (704) 813-4033 |
| NPI Number | 1841579240 |
|---|---|
| Provider Enumeration Date | 08/16/2011 |
| Last Update Date | 10/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841579240 | NPI | - | NPPES |
| 6001164 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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