Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 693 | SC |
Y | 103T00000X | Psychologist | 693 | SC |
NPI | 1013025972 |
---|---|
Provider Name | Ronald E Acierno |
First Address | Charlotte, NC 28275-1461 |
Second Address | Houston, TX 77054-6010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 12/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PS0266 | (05) | SC |
Q31701 | (02) |