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General NPI Number Information
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NPI Number | 1770747636
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Entity Type | Organization
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Legal Business Name | ROCKWELL, INC.
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 3721 BENSON DR
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City | RALEIGH
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State | NC
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Zip | 27609-7324
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Country | US
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Telephone | 919-259-0756
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 HALES RD
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City | RALEIGH
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State | NC
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Zip | 27608-1446
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Country | US
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Telephone | 919-259-0756
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Fax |
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Authorized Official
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Title or Position | LISCENSED PSYCHOLOGICAL ASSOCIATE
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Name | MS. LAUREN ANN ROCKWELL FLICK
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Credential | MA, LPA
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Telephone | 919-259-0756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 1472
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License Number State | NC
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