Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 50 | NC |
NPI | 1346408499 |
---|---|
Provider Name | Dr. Susan Macdonald Roddey |
First Address | Charlotte, NC 28210-4721 |
Second Address | Charlotte, NC 28210-4721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 27/05/2008 |