Individual
MS. NATALIE BROOKE JACOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPA, BCBA
Contact information
Practice address
647 BRAWLEY SCHOOL RD STE 104, MOORESVILLE, NC 28117-6876
(704) 703-8588
Mailing address
104 CHESTNUT ST, DURHAM, NC 27707-1715
(919) 801-8805
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NC
103T00000X
Psychologist
Primary
3564
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3564
NC
Other
Enumeration date
11/15/2011
Last updated
11/29/2022
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