Individual
SANITA A MOULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.C.C., LMFT
Contact information
Practice address
1913 J N PEASE PL, SUITE 104, CHARLOTTE, NC 28262-4556
(704) 236-9675
(704) 548-9247
Mailing address
1913 J N PEASE PL, SUITE 104, CHARLOTTE, NC 28262-4556
(704) 236-9675
(704) 548-9247
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1359
NC
106H00000X
Marriage & Family Therapist
Primary
1359
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1359
NCMFT LICENSURE BORAD
NC
Enumeration date
05/14/2009
Last updated
06/10/2011
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