Provider Demographics
NPI:1083666184
Name:NEMATI, MARY C (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:C
Last Name:NEMATI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2100 FAIRFAX RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-3009
Mailing Address - Country:US
Mailing Address - Phone:336-297-1981
Mailing Address - Fax:336-297-1983
Practice Address - Street 1:2100 FAIRFAX RD
Practice Address - Street 2:SUITE 208
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-3009
Practice Address - Country:US
Practice Address - Phone:336-297-1981
Practice Address - Fax:336-297-1983
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2642103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical