Healthcare Provider Details

I. General information

NPI: 1841436649
Provider Name (Legal Business Name): M & L BEHAVIORAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 BOONE HEIGHTS DR. SUITE 205
BOONE NC
28607
US

IV. Provider business mailing address

102 MEADOW LARK WAY
VILAS NC
28692
US

V. Phone/Fax

Practice location:
  • Phone: 828-773-4337
  • Fax: 828-262-2974
Mailing address:
  • Phone: 828-773-4337
  • Fax: 828-262-2974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberNC2381
License Number StateNC

VIII. Authorized Official

Name: DR. DENISE MICHELE MARTZ
Title or Position: PRESIDENT M & L BEHAVIORAL SERVICES
Credential:
Phone: 828-773-4337