Individual
DR. MARY SANDRA STORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., P.C.
Contact information
Practice address
8512 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-2962
(919) 844-8711
(919) 844-8706
Mailing address
8512 SIX FORKS RD, SUITE 102, RALEIGH, NC 27615-2962
(919) 844-8711
(919) 844-8706
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2659
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000365
—
NC
Enumeration date
04/20/2006
Last updated
07/09/2007
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