Doctor Name: | MARY JERNIGAN |
NPI Number: | 1356695639 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCA |
License Number: | A9047 |
Business Practice Address: | 109 E Oak St Selma, NC - 275762845 |
Business Phone Number: | 9107267310 |
Business Fax Number: | |
Mailing Address: | 3208 Oleander Dr, WILMINGTON |
State: | NC |
Postal Code: | 284030800 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/07/2012 |
NPI Last Update Date: | 12/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | A9047 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |