Organization
KIDS CAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAPHNE TIMMONS PH.D (PSYCHOLOGIST/MANAGER OF CORPORATION)
(704) 364-4133
Entity
Organization
Contact information
Practice address
233 S SHARON AMITY RD, SUITE 103, CHARLOTTE, NC 28211-2880
(704) 364-4133
(704) 364-4134
Mailing address
233 S. SHARON-AMITY ROAD, SUITE 103, CHARLOTTE, NC 28211-2880
(704) 364-4133
(704) 364-4134
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3216
NC
103T00000X
Psychologist
Primary
1130
NC
1041C0700X
Clinical Social Worker
C001983
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000262
—
NC
05
—
6103892
—
NC
Enumeration date
01/02/2009
Last updated
01/02/2009
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