Individual
CONNIE SMITH PHILBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.A.
Contact information
Practice address
1000 N 1ST ST, ALBEMARLE, NC 28001-2833
(704) 983-2117
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
1426
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107204
—
NC
Enumeration date
08/07/2006
Last updated
11/02/2007
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