Individual
JEREMY CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2300 RAMSEY ST, FAYETTEVILLE, NC 28301-3856
(910) 488-2120
Mailing address
830 EAGLES NEST DR, SANFORD, NC 27332-8388
(561) 777-4445
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6069
NC
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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