Individual
JENNIFER M GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
402 HARRIS AVE, RAEFORD, NC 28376-3112
(910) 852-5121
(910) 852-5122
Mailing address
5302 MARYLAND DR, FAYETTEVILLE, NC 28311-1328
(910) 315-9957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P013033
NC
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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