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Contact Information

WAKE INTEGRATIVE BEHAVIORAL MEDICINE, PC
1107 SEVEN LAKES DRIVE
SEVEN LAKES, NC27376
 Phone: 414-847-9351
 Fax: 888-227-7795
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for WAKE INTEGRATIVE BEHAVIORAL MEDICINE PC · (Female)

NPI # 1295254399
Status Active
Credentials
Entity Individual
Enumeration date 09/11/2017
Last updated 06/16/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 3503
  • NC Other 3503 MY LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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