Individual
JASON CHRISTOPHER FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2848
Mailing address
410 HALIFAX DR, FAYETTEVILLE, NC 28303-2123
(910) 916-2059
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-18519
NC
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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