Individual
MRS. JENNIFER SHOPE MYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1100 BLYTHE BLVD, PSYCHOLOGY DEPARTMENT, CHARLOTTE, NC 28203-5814
(704) 355-8262
Mailing address
1100 BLYTHE BLVD, PSYCHOLOGY DEPARTMENT, CHARLOTTE, NC 28203-5814
(704) 355-8262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10360
NC
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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