Individual
DEJA STOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
5820 E W T HARRIS BLVD STE 205, CHARLOTTE, NC 28215-4032
(704) 469-1243
Mailing address
9404 GROVE SIDE LN APT 714, CHARLOTTE, NC 28262-5485
(864) 373-4621
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P017995
NC
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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