Organization
EPIPHANY INTEGRATED CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA H MILLNER (CEO)
(704) 236-4067
Entity
Organization
Contact information
Practice address
4921 ALBEMARLE RD, SUITE 203, CHARLOTTE, NC 28205-6654
(704) 236-4067
Mailing address
4921 ALBEMARLE RD, SUITE 203, CHARLOTTE, NC 28205-6654
(704) 236-4067
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01
—
NC
Enumeration date
01/09/2014
Last updated
01/09/2014
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