Individual
MRS. SHERRY BASS STACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
5801 PINEVILLE MATTHEWS RD, CHARLOTTE, NC 28226-3432
(704) 341-5326
(704) 341-5454
Mailing address
2208 HUMBERVIEW LN, CHARLOTTE, NC 28270-1136
(704) 846-8536
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2503
NC
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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