Individual
JENNYL ALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4908 SPRING MEADOW LN, MONROE, NC 28110-9001
(704) 996-5179
Mailing address
4908 SPRING MEADOW LN, MONROE, NC 28110-9001
(704) 996-5179
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
NC
Enumeration date
07/12/2009
Last updated
11/07/2013
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