MEDICARE: MS. CYNTHIA NEWBY MOBLEY M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0604	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700100815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA NEWBY MOBLEY M.A.

Provider Business Mailing Address
First Line	:	4129 ROSY MOUND LANE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-3259
Country	:	US
Telephone Number	:	704-391-7135
Fax Number	:

Provider Business Practice Location Address
First Line	:	4129 ROSY MOUND LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-3259
Country	:	US
Telephone Number	:	704-391-7135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	05/05/2011

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