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Organization
MASK OFF THERAPEUTIC PLLC
Active
Organization
MASK OFF THERAPEUTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEBA SABAN BOSLEY MSW LCSW (CEO)
(203) 530-0245
Entity
Organization
Contact information
Practice address
8501 TOWER POINT DR, CHARLOTTE, NC 28227-7849
(203) 530-0245
Mailing address
5912 BRIGHTSTAR VALLEY RD, MINT HILL, NC 28227-7691
(203) 530-0245
(704) 910-3057
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041C0700X
—
NC
Enumeration date
03/25/2020
Last updated
03/25/2020
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