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General NPI Number Information
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NPI Number | 1851431795
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Entity Type | Organization
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Legal Business Name | CENTER FOR HOLISTIC PSYCHOTHERAPY
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 1801 E 5TH STREET SUITE 204
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City | CHARLOTTE
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State | NC
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Zip | 28204
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Country | US
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Telephone | 704-375-3545
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Fax | 704-375-3632
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Provider Business Mailing Address
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Address Line | 1801 E 5TH STREET SUITE 204
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City | CHARLOTTE
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State | NC
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Zip | 28204
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Country | US
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Telephone | 704-375-3545
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Fax | 704-375-3632
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Authorized Official
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Title or Position | CO DIRECTOR
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Name | MARY G BOBIS
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Credential | LCSW
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Telephone | 704-332-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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