Individual
ERIC L. DEITCHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
417 S SHARON AMITY RD, A, CHARLOTTE, NC 28211-2868
(704) 364-0452
(704) 364-5481
Mailing address
1824 ASHEVILLE PL, CHARLOTTE, NC 28203-6054
(704) 344-0357
(704) 364-5481
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0892
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03421
BLUE CROSS BLUE SHIELD
NC
Enumeration date
07/14/2006
Last updated
07/08/2007
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