Individual
DEVIN MARTIE XAYASOMLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 BACK CREEK DRIVE, CHARLOTTE, NC 28213
(844) 263-0050
Mailing address
1810 BACK CREEK DR, CHARLOTTE, NC 28213-2159
(448) 263-0050
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C013435
NC
1041C0700X
Clinical Social Worker
Primary
LCSW112035
CA
Other
Enumeration date
09/19/2018
Last updated
04/08/2024
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