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General NPI Number Information
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NPI Number | 1295615060
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Entity Type | Individual
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Provider Name | CAROLINE GRACE TUMULTY-OLLEMAR LMFTA
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Gender | Female
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 5950 FAIRVIEW RD STE 700
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City | CHARLOTTE
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State | NC
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Zip | 28210-0085
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Country | US
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Telephone | 980-255-5335
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 AUTUMN FIELD DR APT 304
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-4043
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Country | US
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Telephone | 980-255-5335
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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 | 20754A
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License Number State | NC
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