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General NPI Number Information
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NPI Number | 1023243540
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Entity Type | Individual
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Provider Name | HEATHER NOEL ANSCHUETZ-JEFFERS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 10001 OLD CONCORD RD
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City | CHARLOTTE
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State | NC
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Zip | 28213
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Country | US
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Telephone | 704-547-7483
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Fax | 704-547-0052
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | NEWELL
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State | NC
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Zip | 28126-0568
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Country | US
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Telephone | 704-547-1483
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Fax | 704-547-0052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3305
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License Number State | NC
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