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General NPI Number Information
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NPI Number | 1811537210
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Entity Type | Organization
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Legal Business Name | AZEVEDO FAMILY PSYCHOLOGY, PA
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 1903 N HARRISON AVE STE 201
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City | CARY
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State | NC
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Zip | 27513-3093
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Country | US
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Telephone | 919-624-9561
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Fax | 919-404-7124
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Provider Business Mailing Address
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Address Line | 1903 N HARRISON AVE STE 201
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City | CARY
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State | NC
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Zip | 27513-3093
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Country | US
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Telephone | 919-624-9561
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Fax | 919-404-7124
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Authorized Official
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Title or Position | OWNER
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Name | DR. DON AZEVEDO
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Credential | PHD
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Telephone | 919-624-9561
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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