Organization
GBAUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMILA SAFIYA NETTLES-FELDER LPC (OWNER)
(803) 984-0124
Entity
Organization
Contact information
Practice address
5111 NATIONS CROSSING RD, BUILDING 8 SUITE 226, CHARLOTTE, NC 28217-2126
(803) 984-0124
(704) 504-5021
Mailing address
5111 NATIONS CROSSING RD, BUILDING 8 SUITE 226, CHARLOTTE, NC 28217-2126
(803) 984-0124
(704) 504-5021
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5431
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103628
—
NC
Enumeration date
06/22/2009
Last updated
06/22/2009
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