Individual
JASMIN ROSELEE CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT PHD
Contact information
Practice address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(919) 606-7723
Mailing address
8406 SIX FORKS RD STE 104, RALEIGH, NC 27615-3075
(919) 424-6045
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1871
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000026168216
DRIVER'S LICENSE
NC
Enumeration date
01/09/2017
Last updated
01/21/2019
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