Individual
MRS. JENNIFER M. DEACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYCH. ASSOCIATE
Contact information
Practice address
512 RIVERSIDE DR, MORGANTON, NC 28655-3727
(828) 403-3353
Mailing address
512 RIVERSIDE DR, MORGANTON, NC 28655-3727
(828) 433-8084
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-12257
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
1982
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107547
—
NC
Enumeration date
01/08/2008
Last updated
07/05/2021
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