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General NPI Number Information
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NPI Number | 1174648208
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Entity Type | Organization
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Legal Business Name | MY CAT KARMA
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 04/09/2010
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Provider Practice Location Address
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Address Line | 11208 IVY CREEK TRL
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City | WAKE FOREST
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State | NC
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Zip | 27587-6438
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Country | US
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Telephone | 919-523-0910
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Fax | 919-562-6588
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Provider Business Mailing Address
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Address Line | 11208 IVY CREEK TRAIL
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City | WAKE FOREST
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State | NC
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Zip | 27582-6438
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Country | US
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Telephone | 919-523-0910
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Fax | 919-562-6588
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Authorized Official
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Title or Position | PRESIDENT MY CAT KARMA INC
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Name | MS. VICKI DAWN ESLICK
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Credential | LCSW
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Telephone | 919-523-0910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | C004514
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C004514
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License Number State | NC
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