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General NPI Number Information
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NPI Number | 1720713308
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Entity Type | Individual
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Provider Name | NATALIE CHRISTINE FOROUZAD
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Gender | Female
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 3926 MIRIAM DR
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City | CHARLOTTE
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State | NC
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Zip | 28205-7726
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Country | US
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Telephone | 704-476-1580
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Fax |
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Provider Business Mailing Address
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Address Line | 13506 ROBERT WALKER DR
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City | DAVIDSON
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State | NC
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Zip | 28036-6008
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Country | US
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Telephone | 704-818-8169
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P017815
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License Number State | NC
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