Organization
CBT CENTER FOR BALANCED LIVING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA POLK (OWNER)
(704) 729-4228
Entity
Organization
Contact information
Practice address
136 MUSSELL LN, MOORESVILLE, NC 28117-3707
(704) 230-7998
Mailing address
132 JOE KNOX AVE, MOORESVILLE, NC 28117-9202
(704) 729-4228
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005872
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6007471
—
NC
Enumeration date
01/08/2013
Last updated
01/08/2013
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