Individual
DR. DAVID BRANTLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
10130 MALLARD CREEK RD, SUITE 300, CHARLOTTE, NC 28262-6000
(704) 944-3112
(704) 944-3113
Mailing address
10130 MALLARD CREEK RD, SUITE 300, CHARLOTTE, NC 28262-6000
(704) 944-3112
(704) 944-3113
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3777
NC
103TC0700X
Clinical Psychologist
Primary
3777
NC
103TC1900X
Counseling Psychologist
3777
NC
103TC2200X
Clinical Child & Adolescent Psychologist
3777
NC
103TH0100X
Health Service Psychologist
3777
NC
103TP2701X
Group Psychotherapy Psychologist
3777
NC
Other
Enumeration date
09/21/2010
Last updated
07/17/2014
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