Organization
JACOB'S LADDER CHILDHOOD THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA JUNE TERRAGO PHD, ABD, LPC (OWNER/DIRECTOR)
(919) 217-2929
Entity
Organization
Contact information
Practice address
8928 US HIGHWAY 70 W, SUITE 100, CLAYTON, NC 27520-4844
(919) 217-2929
(919) 217-2993
Mailing address
8928 US HIGHWAY 70 W, SUITE 100, CLAYTON, NC 27520-4844
(919) 217-2929
(919) 217-2993
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4543
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447444096
—
NC
Enumeration date
08/02/2010
Last updated
08/09/2010
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