Individual
JENNIFER THEIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., L.P.A.
Contact information
Practice address
2460 DELANEY AVE, WILMINGTON, NC 28403-6062
(910) 792-6130
Mailing address
7437 BRIGHT LEAF RD, WILMINGTON, NC 28411-7122
(910) 524-5445
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2102
NC
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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