Provider Demographics
NPI:1285677971
Name:SOTILE, WAYNE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:M
Last Name:SOTILE
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:155 SAINT CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8459
Mailing Address - Country:US
Mailing Address - Phone:336-765-3032
Mailing Address - Fax:336-760-6977
Practice Address - Street 1:SOTILE PSYCHOLOGICAL ASSOCIATES, PLLC
Practice Address - Street 2:1396 OLD MILL CIRCLE
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-765-3032
Practice Address - Fax:336-760-6977
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0776103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical