Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 1374 | NC |
NPI | 1023176781 |
---|---|
Provider Name | Rosa Lee Neaves |
First Address | Lansing, NC 28643-8855 |
Second Address | Lenoir, NC 28645-9691 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6107483 | (05) | NC |