Individual
MARY TAYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3541 RANDOLPH RD, SUITE 206, CHARLOTTE, NC 28211-1082
(704) 381-8336
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1833
NC
Other
Enumeration date
10/05/2006
Last updated
10/04/2019
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