Individual
GEOFFREY BENJAMIN VAN WAVEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
380 COPPERFIELD BLVD NE, CONCORD, NC 28025-2402
(704) 403-1800
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
C002386
NC
Other
Enumeration date
03/01/2006
Last updated
07/15/2024
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