Individual
JETTIE MAE PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 TULANE DR, RAEFORD, NC 28376-8006
(910) 257-7189
(910) 281-2056
Mailing address
131 TULANE DR, RAEFORD, NC 28376-8006
(910) 257-7189
(910) 281-2056
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/27/2015
Last updated
05/03/2016
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