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Individual

DR. AMY SMITH MCNULTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LCSW

Contact information

Practice address
3541 RANDOLPH ROAD, SUITE 102, CHARLOTTE, NC 28211
(704) 366-6969
(704) 366-6464
Mailing address
3541 RANDOLPH ROAD, SUITE 102, CHARLOTTE, NC 28211
(704) 366-6969
(704) 366-6464

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1972
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03128
BCBS
NC
Enumeration date
05/03/2006
Last updated
04/08/2010
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