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Individual

CARMEN NI'ASIA JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
390 S LIBERTY ST, WINSTON SALEM, NC 27101-5260
(336) 934-4058
Mailing address
102 BLOSSOM CIR, LEXINGTON, NC 27292-4183
(980) 312-7608

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
NC

Other

Enumeration date
01/26/2026
Last updated
01/26/2026
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