Organization
FAMILY TREATMENT AND THERAPUETIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA JEAN LEE BA, ED (OWNER/DIRECTOR)
(304) 960-9348
Entity
Organization
Contact information
Practice address
10514 OLD BRIDGE LN, CHARLOTTE, NC 28269-8157
(304) 960-9348
Mailing address
10514 OLD BRIDGE LN, CHARLOTTE, NC 28269-8157
(304) 960-9348
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
252Y00000X
NC
252Y00000X
Early Intervention Provider Agency
251B00000X
NC
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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