Individual
KIM FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
380 COPPERFIELD BLVD NE, CONCORD, NC 28025-2402
(704) 403-1800
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1642
NC
Other
Enumeration date
05/20/2006
Last updated
09/27/2021
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