Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C006485 | NC |
NPI | 1003124496 |
---|---|
Provider Name | Miss Meredith Canty Anderson |
First Address | Charlotte, NC 28213-5267 |
Second Address | Charlotte, NC 28213-5267 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 09/11/2011 |