| Gantt Youth And Family Services Llc | |
|
9635 Southern Pine Blvd Ste 127 Charlotte NC 28273-5563 | |
| (704) 968-4893 | |
| (704) 583-0672 |
| Full Name | Gantt Youth And Family Services Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 9635 Southern Pine Blvd Ste 127, Charlotte, North Carolina |
| Authorized Official Name and Position | Tomeka Gantt (THERAPIST) |
| Authorized Official Contact | 7049684893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gantt Youth And Family Services Llc 10234 Kelso Ct Charlotte NC 28278-6637 Ph: (704) 968-4893 | Gantt Youth And Family Services Llc 9635 Southern Pine Blvd Ste 127 Charlotte NC 28273-5563 Ph: (704) 968-4893 |
| NPI Number | 1235692419 |
|---|---|
| Provider Enumeration Date | 04/13/2019 |
| Last Update Date | 04/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235692419 | NPI | - | NPPES |
| 20191 | Other | NC | LEGALZOOM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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