Individual
JASMINE GABRIELLE CALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
20 PAGE DR, PINEHURST, NC 28374-8847
(910) 235-9090
(910) 235-9093
Mailing address
20 PAGE DR, PINEHURST, NC 28374-8847
(910) 235-9090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28082
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234
—
NC
Enumeration date
03/23/2022
Last updated
03/23/2022
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