Individual
JENNIFER GWALTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
138 FIRST COLONY CT, MANTEO, NC 27954-9256
(252) 573-8090
Mailing address
138 FIRST COLONY CT, MANTEO, NC 27954-9256
(252) 573-8090
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15120
NC
Other
Enumeration date
11/08/2019
Last updated
12/01/2023
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