Individual
NICOLLE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1905 J N PEASE PL, SUITE 104, CHARLOTTE, NC 28262-4557
(704) 599-4679
Mailing address
8728 ARBOR COMMOMS LN, CONCORD, NC 28027-3575
(704) 795-9150
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
102528
NC
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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