Individual
JESSICA LYNN KAWAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
925 S KERR AVE STE B, WILMINGTON, NC 28403-4354
(720) 934-5631
Mailing address
213 MARSH HEN DR, WILMINGTON, NC 28409-3519
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
24237
NC
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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