Individual
JERICA MARIE MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
4012 PARK RD STE 200, CHARLOTTE, NC 28209-2378
(704) 332-4834
Mailing address
9410 FETLOCK CT, CHARLOTTE, NC 28216-1870
(828) 712-9952
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4594
NC
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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