Organization
GANTT PSYCHOTHERAPEUTIC AND CONSULTATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOMEKA MAYS GANTT M.A. (LICENSED PROFESSIONAL COUNSELOR)
(704) 968-4893
Entity
Organization
Contact information
Practice address
10234 KELSO CT, CHARLOTTE, NC 28278-6637
(704) 968-4893
(704) 583-0672
Mailing address
10234 KELSO CT, CHARLOTTE, NC 28278-6637
(704) 968-4893
(704) 583-0672
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4417
NC
101YP2500X
Professional Counselor
4620
SC
251S00000X
Community/Behavioral Health Agency
4417
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102506
—
NC
Enumeration date
05/04/2007
Last updated
01/02/2008
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