| Thera-peds | |
|
1214 Parkway Drive Goldsboro NC 27534-3448 | |
| (919) 739-0047 | |
| (919) 739-0041 |
| Full Name | Thera-peds |
|---|---|
| Speciality | Psychologist |
| Location | 1214 Parkway Drive, Goldsboro, North Carolina |
| Authorized Official Name and Position | Marjorie Pate (OWNER) |
| Authorized Official Contact | 9197390047 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thera-peds Po Box 10723 Goldsboro NC 27532-0723 Ph: (919) 739-0047 | Thera-peds 1214 Parkway Drive Goldsboro NC 27534-3448 Ph: (919) 739-0047 |
| NPI Number | 1033315734 |
|---|---|
| Provider Enumeration Date | 06/21/2007 |
| Last Update Date | 11/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033315734 | NPI | - | NPPES |
| 6005202 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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