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Organization

JENNIFER COOKE STAAT, P.A.

Active
Other names
Northstar Psychology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JENNIFER COOKE STAAT PH.D. (CLINICAL PSYCHOLOGIST)
(910) 547-3093
Entity
Organization

Contact information

Practice address
4608 CEDAR AVE, SUITE 106, WILMINGTON, NC 28403-4419
(910) 547-3093
Mailing address
4608 CEDAR AVE, SUITE 106, WILMINGTON, NC 28403-4419
(910) 547-3093

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2505
NC

Other

Enumeration date
08/18/2008
Last updated
08/18/2008
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