Individual
CARLOS PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAMAFT
Contact information
Practice address
2324 CONCORD LAKE RD, CONCORD, NC 28025-2814
(704) 918-1343
Mailing address
2324 CONCORD LAKE RD, CONCORD, NC 28025-2814
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A14801
NC
Other
Enumeration date
01/31/2019
Last updated
06/10/2019
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