Organization
SOUTHEAST PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK W GASKILL III PH.D. (MANAGING PARTNER)
(704) 552-0116
Entity
Organization
Contact information
Practice address
6060 PIEDMONT ROW DR S, SUITE 120, CHARLOTTE, NC 28287-3884
(704) 552-0116
(704) 552-7550
Mailing address
6060 PIEDMONT ROW DR S, SUITE 120, CHARLOTTE, NC 28287-3884
(704) 552-0116
(704) 552-7550
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
CO5021
NC
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005111
—
NC
Enumeration date
12/29/2006
Last updated
11/25/2014
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