Individual
JACQUELINE WOOD MARDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
6855 BRYANSTONE WAY, FAYETTEVILLE, NC 28314-5313
(910) 868-5266
Mailing address
6855 BRYANSTONE WAY, FAYETTEVILLE, NC 28314-5313
(910) 868-5266
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2939
NC
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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