Individual
DR. JENNIFER MODE SPACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
109 BRADFORD AVE, FAYETTEVILLE, NC 28301-5401
(910) 488-2120
Mailing address
109 BRADFORD AVE, FAYETTEVILLE, NC 28301-5401
(910) 829-9017
(910) 485-4752
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
271874-2501
UT
103TC0700X
Clinical Psychologist
5201
NC
Other
Enumeration date
10/15/2006
Last updated
06/13/2019
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