Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3272 | NC |
Y | 103T00000X | Psychologist | 3272 | NC |
N | 103G00000X | Clinical Psychologist | 3272 | NC |
N | 103TC0700X | Clinical Psychologist | 3272 | NC |
NPI | 1013028455 |
---|---|
Provider Name | Dr. Rebecca Griffin Smith |
First Address | Charlotte, NC 28211-1118 |
Second Address | Charlotte, NC 28211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 20/10/2021 |