Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 624 | NC |
NPI | 1043315450 |
---|---|
Provider Name | Mr. Robert J Mccurry |
First Address | Greensboro, NC 27401-2674 |
Second Address | Greensboro, NC 27401-2674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6102442 | (05) | NC |