Organization
CHILD AND FAMILY DEVELOPMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA CATHERINE TIEDEMAN (BILLING AND MEDICAL RECORDS MANAGER)
(704) 332-4834
Entity
Organization
Contact information
Practice address
4012 PARK RD, SUITE 200, CHARLOTTE, NC 28209-2378
(704) 332-4834
(704) 372-9653
Mailing address
4012 PARK RD STE 200, CHARLOTTE, NC 28209-2378
(704) 332-4834
(704) 372-9653
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
720103C
—
NC
05
—
7211539
—
NC
Enumeration date
02/24/2006
Last updated
01/29/2024
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