Individual
ANDREW SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
180 PROVIDENCE RD, STE 2, CHAPEL HILL, NC 27514-2206
(919) 493-3376
Mailing address
180 PROVIDENCE RD, STE 2, CHAPEL HILL, NC 27514-2206
(919) 493-3376
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
911
NC
103TB0200X
Cognitive & Behavioral Psychologist
911
NC
103TC0700X
Clinical Psychologist
Primary
0911
NC
103TC2200X
Clinical Child & Adolescent Psychologist
911
NC
103TF0000X
Family Psychologist
911
NC
103TF0200X
Forensic Psychologist
911
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
911
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000132
—
NC
Enumeration date
10/10/2006
Last updated
03/19/2012
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