Individual
DR. JASON BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
15720 BRIXHAM HILL AVENUE, 150, CHARLOTTE, NC 28227
(704) 970-4791
Mailing address
30 HOBCAW DR, GREER, SC 29650-4416
(864) 905-8195
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3627
CT
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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