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General NPI Number Information
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NPI Number | 1285938423
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Entity Type | Organization
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Legal Business Name | TRIANGLE LEARNING AND DEVELOPMENT RESOURCES PC
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 02/23/2013
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Provider Practice Location Address
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Address Line | 209 LLOYD ST SUITE 230
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City | CARRBORO
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State | NC
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Zip | 27510-1857
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Country | US
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Telephone | 919-886-4437
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Fax | 919-928-5097
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Provider Business Mailing Address
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Address Line | 209 LLOYD ST SUITE 230
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City | CARRBORO
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State | NC
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Zip | 27510-1857
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Country | US
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Telephone | 919-886-4437
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Fax | 919-928-5097
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | JAMIE ALLISON
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Credential | M.ED
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Telephone | 919-886-4437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1925
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License Number State | NC
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