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General NPI Number Information
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NPI Number | 1760674493
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Entity Type | Organization
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Legal Business Name | MURRAY CHILD PSYCHOLOGICAL SERVICES, INC.
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 4351 MAIN ST SUITE 204
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City | HARRISBURG
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State | NC
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Zip | 28075-7427
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Country | US
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Telephone | 704-455-2213
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Fax | 704-455-2246
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Provider Business Mailing Address
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Address Line | 4351 MAIN ST SUITE 204
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City | HARRISBURG
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State | NC
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Zip | 28075-7427
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Country | US
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Telephone | 704-455-2213
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Fax | 704-455-2246
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TONYA SUSAN MURRAY
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Credential | M.S.., S.S.P.
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Telephone | 704-455-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2229
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License Number State | NC
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