Individual
RICHARD WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A./LPA
Contact information
Practice address
3015 CHINA BERRY CT, MATTHEWS, NC 28104-4314
(704) 534-6014
Mailing address
3015 CHINA BERRY CT, MATTHEWS, NC 28104-4314
(704) 534-6014
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
797
NC
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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