Individual
MISS JESSICA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA LPC
Contact information
Practice address
1133 MILITARY CUTOFF RD, SUITE 200, WILMINGTON, NC 28405-3684
(910) 791-5575
(910) 799-5576
Mailing address
1133 MILITARY CUTOFF RD, SUITE 200, WILMINGTON, NC 28405-4086
(910) 791-5575
(910) 799-5576
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
4808
NC
103T00000X
Psychologist
Primary
2411
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1408C
BLUE CROSS BLUE SHIED
NC
01
—
344161
TRICARE
NC
05
—
6107095
—
NC
Enumeration date
12/19/2005
Last updated
11/16/2009
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