Organization Name: | PSYCHOTHERAPEUTIC SERVICES, INC |
NPI Number: | 1013057009 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RANDALL COOPER (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 1159 Huffman Mill Rd Burlington |
State: | NC US |
Postal Code: | 272158862 |
Phone Number: | 3365386990 |
Fax Number: | 3365386991 |
NPI Enumeration Date: | 02/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TP2701X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Group Psychotherapy |
Taxonomy Definition: |