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General NPI Number Information
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NPI Number | 1073227872
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Entity Type | Organization
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Legal Business Name | IAMHONORED INC
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Dates
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Enumeration Date | 01/06/2023
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 3001 WESTBURY LAKE DR APT Q
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City | CHARLOTTE
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State | NC
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Zip | 28269-2244
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Country | US
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Telephone | 334-655-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 WESTBURY LAKE DR APT Q
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City | CHARLOTTE
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State | NC
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Zip | 28269-2244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. MARVA RENAE LEWIS
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Credential | LCMHC-A
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Telephone | 334-655-2944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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