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General NPI Number Information
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NPI Number | 1255593042
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Entity Type | Organization
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Legal Business Name | PATRICIA G. ROBERTS LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 146 WIND CHIME CT
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City | RALEIGH
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State | NC
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Zip | 27615-6433
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Country | US
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Telephone | 919-622-1456
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Fax | 10-785-0397
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Provider Business Mailing Address
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Address Line | 146 WIND CHIME CT
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City | RALEIGH
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State | NC
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Zip | 27615-6433
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Country | US
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Telephone | 919-622-1456
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Fax | 10-785-0397
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Authorized Official
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Title or Position | MANAGER
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Name | PARTRICIA G ROBERTS
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Credential | LLC
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Telephone | 919-622-1456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2951
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License Number State | NC
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