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Individual

JENNA LYNN KELLEY HAQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
145 SCALEYBARK RD STE B, CHARLOTTE, NC 28209-2682
(704) 717-2809
Mailing address
11508 FALLING LEAVES DR, CHARLOTTE, NC 28277-9129

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
12059A
NC
106H00000X
Marriage & Family Therapist
Primary
2149
NC

Other

Enumeration date
01/24/2018
Last updated
07/22/2020
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