Individual
JENNIFER DIANNE CONRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7621 PURFOY RD STE 105B, FUQUAY VARINA, NC 27526-6985
(833) 749-4584
Mailing address
407 N SUMNER ST, SELMA, NC 27576-2530
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A18124
NC
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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