Individual
MR. PAUL PICKETT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4708 TWISTED OAKS RD APT 104, CHARLOTTE, NC 28212-7317
(704) 456-8120
(704) 509-9208
Mailing address
4708 TWISTED OAKS RD APT 104, CHARLOTTE, NC 28212-7317
(704) 456-8120
(704) 509-9208
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
NC
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619442076
—
NC
Enumeration date
10/11/2018
Last updated
02/19/2020
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