Organization
PSYCHOTHERAPEUTIC SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL COOPER CPA (CFO)
(410) 778-9114
Entity
Organization
Contact information
Practice address
3 CENTERVIEW DR, GREENSBORO, NC 27407-3725
(252) 756-1005
(252) 756-1085
Mailing address
870 HIGH ST, SUITE 2, CHESTERTOWN, MD 21620-3909
(410) 778-9114
(410) 778-7988
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8301699
—
NC
Enumeration date
08/31/2007
Last updated
08/31/2007
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