Individual
PHILITA WING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7721 PETREA LN, CHARLOTTE, NC 28227-1061
(803) 522-1958
Mailing address
7721 PETREA LN, CHARLOTTE, NC 28227-1061
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
02/02/2026
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