Individual
PROF. CHRISTY MANGIONE WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
4388
NC
103TS0200X
School Psychologist
Primary
4388
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1752W
BCBSNC
NC
05
—
6001394
—
NC
Enumeration date
07/18/2011
Last updated
07/15/2013
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