Individual
COLLYTTE DIANA CEDERSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
609 S NEW HOPE RD STE 102, GASTONIA, NC 28054-4825
(704) 208-1865
(704) 208-1865
Mailing address
14 HAMILTONS BAY CT APT 506, LAKE WYLIE, SC 29710-9040
(803) 242-2082
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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