Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C008385 | NC |
NPI | 1003202979 |
---|---|
Provider Name | Caroline Corzine |
First Address | Matthews, NC 28105-9121 |
Second Address | Waxhaw, NC 28173-6607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 17/03/2018 |