Individual
MS. JOAN DOREEN IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.P.A
Contact information
Practice address
3205 FREEDOM DR STE 7500, CHARLOTTE, NC 28208-3490
(704) 517-4632
(252) 633-1548
Mailing address
6711 LINDA LAKE DR, CHARLOTTE, NC 28215-4008
(252) 658-5522
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046CC
BLUE CROSS BLUE SHIELD
NC
01
—
487799200
EPA WORK COMP
NC
05
—
6107164
—
NC
01
—
D4850
MEDCOST
NC
Enumeration date
05/11/2006
Last updated
07/26/2023
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