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Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC
Active
Organization
EASTER SEALS UCP NORTH CAROLINA & VIRGINIA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD EDWARDS (VP SERVICE LINE)
(919) 783-8898
Entity
Organization
Contact information
Practice address
10150 MALLARD CREEK RD, SUITE 510, CHARLOTTE, NC 28262-9708
(704) 333-8220
Mailing address
200 WEBB BLVD, PO BOX 629, HAVELOCK, NC 28532-1930
(252) 447-3892
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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