Organization
VINSON PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA ANNE VINSON PHD (CLINICAL PSYCHOLOGIST)
(336) 972-1164
Entity
Organization
Contact information
Practice address
4236 SHERLIE WEAVIL RD, WINSTON SALEM, NC 27107
(336) 972-1164
Mailing address
4236 SHERLIE WEAVIL RD, WINSTON-SALEM, NC 27107
(336) 972-1164
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
1596
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6006146
—
NC
Enumeration date
03/20/2013
Last updated
05/29/2013
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