Individual
BRENNA SLOAN DETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
704 RADIANT DR, JACKSONVILLE, NC 28546-8425
(561) 676-0575
Mailing address
704 RADIANT DR, JACKSONVILLE, NC 28546-8425
(561) 676-0575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20795
NC
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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