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General NPI Number Information
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NPI Number | 1336336023
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Entity Type | Organization
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Legal Business Name | PARKTOWNE PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 1515 MOCKINGBIRD LN SUITE 212
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City | CHARLOTTE
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State | NC
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Zip | 28209-3236
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Country | US
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Telephone | 704-522-8490
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 MOCKINGBIRD LN SUITE 212
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City | CHARLOTTE
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State | NC
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Zip | 28209-3236
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Country | US
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Telephone | 704-522-8490
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. MARVIN BURT POSTON JR.
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Credential | PSY.D.
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Telephone | 704-522-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1746
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License Number State | NC
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