Individual
DR. CARLY BOBAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5960 FAIRVIEW RD STE 302, CHARLOTTE, NC 28210-3102
(704) 966-9010
Mailing address
114 BRETON CT, MOORESVILLE, NC 28117-5962
(518) 527-0134
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
103409
NC
103TB0200X
Cognitive & Behavioral Psychologist
103409
NC
103TC0700X
Clinical Psychologist
103409
NC
103TC2200X
Clinical Child & Adolescent Psychologist
103409
NC
103TF0000X
Family Psychologist
103409
NC
103TH0100X
Health Service Psychologist
103409
NC
103TS0200X
School Psychologist
103409
NC
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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