| Easter Seals Ucp North Carolina & Virginia, Inc | |
|
10150 Mallard Creek Rd Suite 510 Charlotte NC 28262-9708 | |
| (704) 333-8220 | |
| Not Available |
| Full Name | Easter Seals Ucp North Carolina & Virginia, Inc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 10150 Mallard Creek Rd, Charlotte, North Carolina |
| Authorized Official Name and Position | Richard Edwards (VP SERVICE LINE) |
| Authorized Official Contact | 9197838898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals Ucp North Carolina & Virginia, Inc 200 Webb Blvd Po Box 629 Havelock NC 28532-1930 Ph: (252) 447-3892 | Easter Seals Ucp North Carolina & Virginia, Inc 10150 Mallard Creek Rd Suite 510 Charlotte NC 28262-9708 Ph: (704) 333-8220 |
| NPI Number | 1861838492 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 05/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861838492 | NPI | - | NPPES |
| 7200481 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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