Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | C009596 | NC |
NPI | 1003257023 |
---|---|
Provider Name | Mr. Andre Maurice Harvey |
First Address | Charlotte, NC 28213-3501 |
Second Address | Charlotte, NC 28262-2367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2013 |
Last Update Date | 06/02/2019 |