Individual
DR. JAMMIE NOEL RAINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
800 BRIAR CREEK ROAD, SUITE BB-400 THE PARK EXPO & CONFERENCE CENTER, CHARLOTTE, NC 28205-6903
(704) 408-3703
(704) 537-9356
Mailing address
7310 MIDDLEBURY PL, CHARLOTTE, NC 28212-4721
(704) 532-8438
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2514
NC
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2514
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045JG
BCBS
NC
05
—
6000469
—
NC
01
—
D1402
MEDCOST PROVIDER #
NC
Enumeration date
03/13/2007
Last updated
08/09/2012
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