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Individual

MR. BIRCHIE ST. CLAIR WARREN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA,LPA,HSP-PA

Contact information

Practice address
5300 PINEHALL WYND, RALEIGH, NC 27604-5986
(919) 212-3630
Mailing address
5300 PINEHALL WYND, RALEIGH, NC 27604-5986
(919) 212-3630

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1357
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1357
NC PSYCHOLOGY LICENSE
NC
05
6107400
NC
Enumeration date
02/14/2007
Last updated
07/08/2007
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