Individual
DR. TERI SHONTELLE MACQUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6733 FAIRVIEW RD, SUITE B, CHARLOTTE, NC 28210-3382
(704) 560-0023
Mailing address
6733 FAIRVIEW RD, SUITE B, CHARLOTTE, NC 28210-3382
(704) 560-0023
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2930
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046ET
BCBS
NC
05
—
6000670
—
NC
01
—
7040485
AETNA
NC
Enumeration date
12/29/2006
Last updated
07/09/2007
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