Individual
JACLYN BOUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA COUNSELING
Contact information
Practice address
3804 PARK AVE STE C, WILMINGTON, NC 28403-6737
(910) 240-4473
Mailing address
3804 PARK AVE STE C, WILMINGTON, NC 28403-6737
(910) 240-4473
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20348
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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