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General NPI Number Information
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NPI Number | 1114292158
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Entity Type | Individual
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Provider Name | FERZIN RUSTOM IRANI LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 11/20/2012
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Provider Practice Location Address
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Address Line | 3200 WAKE FOREST ROAD SUITE 200
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City | RALEIGH
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State | NC
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Zip | 27609
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Country | US
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Telephone | 919-872-1441
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Fax | 919-872-1455
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Provider Business Mailing Address
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Address Line | 1002 WILLOW DR APT 27
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City | CHAPEL HILL
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State | NC
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Zip | 27514-2934
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Country | US
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Telephone | 714-287-8163
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1428
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License Number State | NC
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