| Mask Off Therapeutic Pllc | |
|
8501 Tower Point Dr Charlotte NC 28227-7849 | |
| (203) 530-0245 | |
| Not Available |
| Full Name | Mask Off Therapeutic Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 8501 Tower Point Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Keba Saban Bosley (CEO) |
| Authorized Official Contact | 2035300245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mask Off Therapeutic Pllc 5912 Brightstar Valley Rd Mint Hill NC 28227-7691 Ph: (203) 530-0245 | Mask Off Therapeutic Pllc 8501 Tower Point Dr Charlotte NC 28227-7849 Ph: (203) 530-0245 |
| NPI Number | 1104453547 |
|---|---|
| Provider Enumeration Date | 03/25/2020 |
| Last Update Date | 03/25/2020 |
| Certification Date | 03/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104453547 | NPI | - | NPPES |
| 1041C0700X | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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