Individual
JEWEL ANTIQUAL MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
420 FAIRLEY STREET, LAURINBURG, NC 28352
(910) 649-7313
Mailing address
420 FAIRLEY STREET, LAURINBURG, NC 28352
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3234-A
NC
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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