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915 Tate Blvd Se Ste 186 Hickory NC 28602-4042 | |
| (615) 920-7000 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 915 Tate Blvd Se, Hickory, North Carolina |
| Authorized Official Name and Position | Jess Judy (PRESIDENT) |
| Authorized Official Contact | 6159207000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
915 Tate Blvd Se Ste 186 Hickory NC 28602-4042 Ph: (615) 920-7000 | 915 Tate Blvd Se Ste 186 Hickory NC 28602-4042 Ph: (615) 920-7000 |
| NPI Number | 1780041327 |
|---|---|
| Provider Enumeration Date | 01/27/2016 |
| Last Update Date | 01/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780041327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
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