Individual
MRS. JESSICA DANYELLE FAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
8406 SIX FORKS RD, RALEIGH, NC 27615-3074
(919) 617-9656
Mailing address
8406 SIX FORKS RD STE 204, RALEIGH, NC 27615-3074
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
12056A
NC
Other
Enumeration date
08/28/2017
Last updated
09/17/2017
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