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Individual

MRS. JESSICA LYNN BUTCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPA

Contact information

Practice address
8401 UNIVERSITY EXEC PARK DR STE 106, CHARLOTTE, NC 28262-1360
(800) 311-7072
Mailing address
4102 BREEZEWOOD DR APT 104, WILMINGTON, NC 28412-5159
(910) 391-5187

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5289
NC

Other

Enumeration date
05/23/2018
Last updated
05/23/2018
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