| Doctor Name: | JENNIFER BROOKE GREGORY |
| NPI Number: | 1164756045 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 7499 |
| Business Practice Address: | 787 E Pine St Mount Airy, NC - 270303931 |
| Business Phone Number: | 3367894408 |
| Business Fax Number: | 3367864408 |
| Mailing Address: | 787 E Pine St, MOUNT AIRY |
| State: | NC |
| Postal Code: | 270303931 |
| Phone Number: | 3367894408 |
| Fax Number: | 3367864408 |
| NPI Enumeration Date: | 09/25/2009 |
| NPI Last Update Date: | 09/25/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 7499 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |