Provider First Line Business Practice Location Address:
2310 STINSON DR
Provider Second Line Business Practice Location Address:
NCSU DEPARTMENT OF PSYCHOLOGY POE HALL RM 640
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27695-7650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-515-1713
Provider Business Practice Location Address Fax Number:
919-515-1716
Provider Enumeration Date:
08/24/2006