Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 12981 | NC |
NPI | 1003203530 |
---|---|
Provider Name | Meredith Garofalo |
First Address | Charlotte, NC 28205 |
Second Address | Charlotte, NC 28205-6017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 20/07/2017 |