Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 8976 | NC |
Y | 101YS0200X | School Counselor | NC |
NPI | 1194078550 |
---|---|
Provider Name | Mrs. Gabrielle Sledge |
First Address | Charlotte, NC 28273-8014 |
Second Address | Charlotte, NC 28216-4303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2012 |
Last Update Date | 05/01/2015 |