Southlake Center For Self Discovery | |
903 Northeast Dr Ste 201 Davidson NC 28036-7438 | |
(704) 896-7776 | |
(704) 896-0992 |
Full Name | Southlake Center For Self Discovery |
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Speciality | Social Worker - Clinical |
Location | 903 Northeast Dr Ste 201, Davidson, North Carolina |
Authorized Official Name and Position | Kimberly Krueger (OWNER DIRECTOR) |
Authorized Official Contact | 7048967776 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Southlake Center For Self Discovery 903 Northeast Dr Ste 201 Davidson NC 28036-7438 Ph: (704) 896-7776 | Southlake Center For Self Discovery 903 Northeast Dr Ste 201 Davidson NC 28036-7438 Ph: (704) 896-7776 |
NPI Number | 1366656910 |
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Provider Enumeration Date | 05/10/2007 |
Last Update Date | 06/23/2009 |
Identifier | Type | State | Issuer |
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1366656910 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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