Provider Information for 1003171216
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DENISE DOSTER LCSW
Sex: Female
NPI: 1003171216
Last Updated: 2017-03-01
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1003171216 | ||||||||
| Enumeration Date | 2012-07-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5505 DOVERSTONE CT CHARLOTTE, NC 28208-2472 United States Phone: 704-965-0213 | Fax:980-299-1277 | ||||||||
| Primary Practice Address | 10801 JOHNSTON RD SUITE 227 CHARLOTTE, NC 28226-4558 United States Phone: 980-299-1277 | Fax: | ||||||||
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