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Organization

ITHERAPYRX

Active
Other names
itherapy
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROL KELLEY PULLEY L.P.A. (LICENSED PSYCHOLOGICAL ASSOCIATE)
(828) 964-8790
Entity
Organization

Contact information

Practice address
115 ATWOOD ST, SPARTA, NC 28675-9299
(828) 964-8790
Mailing address
PO BOX 56, ROARING GAP, NC 28668-0056
(828) 964-8790

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
3453
NC
103TP2701X
Group Psychotherapy Psychologist
3453
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1710167051
INDIVIDUAL NPI
NC
Enumeration date
11/22/2013
Last updated
11/22/2013
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