Individual
JEREMY MICHAEL GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1601 JONES FRANKLIN RD, RALEIGH, NC 27606-0002
(919) 851-1527
Mailing address
2616 BROADLANDS DRIVE, RALEIGH, NC 27604
(919) 901-9632
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750539516
—
NC
Enumeration date
06/28/2017
Last updated
06/28/2017
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