Organization
CHARLOTTE PSYCHOLOGICAL ASSESSMENT II PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE LACOSTE CANTLEY PH.D. (PRESIDENT/PSYCHOLOGIST)
(704) 841-1163
Entity
Organization
Contact information
Practice address
3303 LATROBE DR, CHARLOTTE, NC 28211-4851
(704) 362-2663
(704) 362-2836
Mailing address
1811 SARDIS RD N, SUITE 207, CHARLOTTE, NC 28270-1426
(704) 841-1163
(704) 841-1164
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3520
NC
Other
Enumeration date
06/29/2010
Last updated
06/29/2010
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