Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ||
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003282021 |
---|---|
Provider Name | Erin Haverkamp |
First Address | Mooresville, NC 28117-4962 |
Second Address | Mooresville, NC 28117-5544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2015 |
Last Update Date | 31/03/2020 |