Individual
DR. JENNIFER BRUCKMAN HAWTHORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., PSY.D.
Contact information
Practice address
8440 REA ROAD, SUITE M, CHARLOTTE, NC 28277-6711
(704) 608-8091
Mailing address
8440 REA ROAD, SUITE M, CHARLOTTE, NC 28277-6711
(704) 608-8091
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3582
NC
Other
Enumeration date
07/02/2007
Last updated
03/15/2010
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