Individual
DR. JONATHAN MARK ANSLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
6115 PARK SOUTH DR, SUITE 130, CHARLOTTE, NC 28210
(704) 552-0116
(704) 552-7550
Mailing address
6115 PARK SOUTH DR, SUITE 130, CHARLOTTE, NC 28210
(704) 552-0116
(704) 552-7550
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3262
NC
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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