Provider Demographics
NPI:1922245380
Name:PEARLMAN, AUDREY (BS)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:PEARLMAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 SIMMON TREE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-0676
Mailing Address - Country:US
Mailing Address - Phone:704-995-2900
Mailing Address - Fax:704-846-2958
Practice Address - Street 1:3007 SIMMON TREE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-0676
Practice Address - Country:US
Practice Address - Phone:704-995-2900
Practice Address - Fax:704-846-2958
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist