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General NPI Number Information
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NPI Number | 1730575804
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Entity Type | Organization
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Legal Business Name | DEBORAH A GREGOR
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 4726 PARK RD STE B
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City | CHARLOTTE
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State | NC
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Zip | 28209-3375
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Country | US
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Telephone | 980-272-8680
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Fax |
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Provider Business Mailing Address
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Address Line | 3822 ABINGDON RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-3749
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Country | US
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Telephone | 704-910-1483
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Fax | 704-910-1483
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MS. DEBORAH A GREGOR
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Credential | LMFTA, RN
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Telephone | 980-272-8680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 9058A
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License Number State | NC
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