Individual
MICHAEL PASQUALE IEZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1018 BROAD ST, DURHAM, NC 27705-4144
(919) 695-3299
Mailing address
1018 BROAD ST, DURHAM, NC 27705-4144
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
4947
NC
Other
Enumeration date
10/08/2018
Last updated
09/13/2019
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