Individual
MICHAEL P MACHOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA, LPA
Contact information
Practice address
10926 S TRYON ST STE E, CHARLOTTE, NC 28273-4154
(704) 931-8870
(866) 313-7602
Mailing address
10926 S TRYON ST STE E, CHARLOTTE, NC 28273-4154
(704) 931-8870
(866) 313-7602
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
Primary
4297
NC
103TB0200X
Cognitive & Behavioral Psychologist
4297
NC
103TS0200X
School Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487904041
NPPES
NC
05
—
6107742
—
NC
Enumeration date
12/20/2011
Last updated
12/14/2020
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