Individual
MRS. JENNIE LEE MCCRILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
(704) 824-3999
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-4999
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-29416
NC
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
07/20/2014
Last updated
09/08/2020
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