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Organization
CONVERSION THERAPEUTIC SERVICES INC
Active
Organization
CONVERSION THERAPEUTIC SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENICIA WASHINGTON PMHNP, FNP, CRNP (OWNER)
(443) 531-1988
Entity
Organization
Contact information
Practice address
11535 CARMEL COMMONS BLVD STE 102, CHARLOTTE, NC 28226-5314
(704) 910-1788
Mailing address
848 KATHY DIANNE DR, INDIAN LAND, SC 29707-6898
(443) 531-1988
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/06/2024
Last updated
10/08/2024
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