Organization
WAKE INTEGRATIVE BEHAVIORAL MEDICINE, PC
Active
Organization
WAKE INTEGRATIVE BEHAVIORAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL YVONNE SMITH PHD, PHD, HSP (CEO/PRESIDENT/OWNER)
(414) 847-9351
Entity
Organization
Contact information
Practice address
1107 SEVEN LAKES DRIVE, SEVEN LAKES, NC 27376
(414) 847-9351
(888) 227-7795
Mailing address
80 BLAKE BLVD UNIT 3038, PINEHURST, NC 28374-9599
(414) 847-9351
(888) 822-7227
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3503
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3503
MY LICENSE
NC
Enumeration date
09/11/2017
Last updated
06/16/2018
Update your record
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