Healthcare Provider Details

I. General information

NPI: 1083859540
Provider Name (Legal Business Name): CENTER FOR PSYCHOLOGY & EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EUROPA DR STE 330
CHAPEL HILL NC
27517-2357
US

IV. Provider business mailing address

100 EUROPA DR STE 330
CHAPEL HILL NC
27517-2357
US

V. Phone/Fax

Practice location:
  • Phone: 919-928-0144
  • Fax: 911-928-0145
Mailing address:
  • Phone: 919-928-0144
  • Fax: 911-928-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number3039
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2058
License Number StateNC

VIII. Authorized Official

Name: MRS. MARIE DEAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 919-928-0144