Individual
JESSICA SQUIRES CARLYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
313 CLIFTON ST, GREENVILLE, NC 27858-5008
(252) 353-0100
Mailing address
2206 KATHLEEN DR, GREENVILLE, NC 27858-9578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A20041
NC
Other
Enumeration date
05/29/2024
Last updated
06/26/2024
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