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General NPI Number Information
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NPI Number | 1366920712
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Entity Type | Organization
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Legal Business Name | ROBBIE MAE & ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/29/2018
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Last Update Date | 07/29/2018
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Provider Practice Location Address
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Address Line | 4020 LAKOTA CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-4074
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Country | US
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Telephone | 704-813-4033
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 LAKOTA CT
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City | CHARLOTTE
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State | NC
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Zip | 28269-4074
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Country | US
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Telephone | 704-813-4033
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANETHIA MOORE
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Credential | LCAS-A, RBT
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Telephone | 704-418-8525
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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 |
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License Number State | NC
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