Individual
MRS. JACQUELYN RENEE HARTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
111 WINDEL DR, RALEIGH, NC 27609-4475
(919) 867-4042
Mailing address
125 DEER VIEW DR, WILLOW SPRING, NC 27592-8559
(919) 867-4042
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8527
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104773
—
NC
Enumeration date
04/05/2011
Last updated
06/05/2015
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