Individual
JESSICA ANN REVELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., M.A., LPCA
Contact information
Practice address
1415 WEST NORTH CAROLINA 54, BUILDING 100 SUITE # 204, DURHAM, NC 27707
(919) 308-6039
Mailing address
100 STRATFORD LAKES DR UNIT 253, DURHAM, NC 27713-3486
(919) 308-6039
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A14340
NC
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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