Organization
RALEIGH PSYCHOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACKELIN JENNIFER VELOZ JEFFERSON LPA, ED.S. (OWNER)
(919) 274-4476
Entity
Organization
Contact information
Practice address
122 W VERNON AVE, WAKE FOREST, NC 27587-2816
(919) 274-4476
(919) 554-9232
Mailing address
122 W VERNON AVE, WAKE FOREST, NC 27587-2816
(919) 274-4476
(919) 554-9232
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2501
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107214
—
NC
Enumeration date
06/01/2015
Last updated
06/01/2015
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