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General NPI Number Information
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NPI Number | 1407725716
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Entity Type | Organization
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Legal Business Name | MODERN WELLNESS PSYCHIATRIC & FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 10410 PARK RD STE 200B
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City | CHARLOTTE
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State | NC
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Zip | 28210-8474
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Country | US
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Telephone | 828-767-0067
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Fax |
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Provider Business Mailing Address
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Address Line | 52 FOREST DR
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City | TRAVELERS REST
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State | SC
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Zip | 29690-9112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IRINA KOPT-ABRAMS
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Credential |
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Telephone | 828-767-0067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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