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General NPI Number Information
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NPI Number | 1699151985
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Entity Type | Organization
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Legal Business Name | CAROLINA COMPLETE PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 5950 FAIRVIEW ROAD SUITE 708
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City | CHARLOTTE
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State | NC
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Zip | 28210
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Country | US
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Telephone | 704-503-9884
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Fax | 704-870-3968
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Provider Business Mailing Address
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Address Line | 5950 FAIRVIEW ROAD SUITE 708
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City | CHARLOTTE
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State | NC
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Zip | 28210
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Country | US
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Telephone | 704-503-9884
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Fax | 704-870-3968
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Authorized Official
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Title or Position | PA-C/OWNER
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Name | MRS. RACHEL L. HOLZHAUER
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Credential | PA-C
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Telephone | 704-503-9884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0100-04002
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License Number State | NC
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