Individual
DR. THEA OCULATO SILVA DE SOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
18151 W CATAWBA AVE, CORNELIUS, NC 28031-5641
(704) 495-4435
Mailing address
4614 BROWNES FERRY RD, CHARLOTTE, NC 28269-8923
(704) 655-2830
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5306
NC
103TH0100X
Health Service Psychologist
5306
NC
Other
Enumeration date
01/22/2018
Last updated
01/10/2019
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