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Organization
REBELLIOUS THERAPY
Active
Organization
REBELLIOUS THERAPY
Active
Other names
Rebellious Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE LEE ELIZABETH WALDRON M.A, LCMHCA, NCC, CT (CEO)
(704) 290-9780
Entity
Organization
Contact information
Practice address
9808 HOLLY CENTER DR APT 204, HUNTERSVILLE, NC 28078-5112
(704) 290-9780
Mailing address
9808 HOLLY CENTER DR APT 204, HUNTERSVILLE, NC 28078-5112
(704) 290-9780
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/10/2022
Last updated
03/15/2022
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