Provider Demographics
NPI:1730309782
Name:PARDO, ROSALBA (PSYD)
Entity Type:Individual
Prefix:
First Name:ROSALBA
Middle Name:
Last Name:PARDO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1669
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-1669
Mailing Address - Country:US
Mailing Address - Phone:704-500-0087
Mailing Address - Fax:704-500-2720
Practice Address - Street 1:259 N KELLY ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5209
Practice Address - Country:US
Practice Address - Phone:704-500-0087
Practice Address - Fax:704-500-2720
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist