Organization
LIFESPAN PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON D SCHNEIDER DR. (OWNER)
(828) 894-2300
Entity
Organization
Contact information
Practice address
801 W MILLS ST, SIUTE B, COLUMBUS, NC 28722-8494
(828) 894-2300
Mailing address
PO BOX 1085, COLUMBUS, NC 28722-1085
(828) 894-2300
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1908
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000122
—
NC
Enumeration date
06/27/2008
Last updated
09/05/2008
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