Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 5829 | NC |
Y | 103T00000X | Psychologist | 5829 | NC |
NPI | 1013519156 |
---|---|
Provider Name | Olivia Cometti |
First Address | Mooresville, NC 28117-8026 |
Second Address | Mooresville, NC 28117-8026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2020 |
Last Update Date | 25/11/2020 |