Individual
KRISTEN MICHELLE LEVERENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
Mailing address
200 TARPON TRL, JACKSONVILLE, NC 28546-5287
(910) 938-1114
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
103627
NC
Other
Enumeration date
01/29/2025
Last updated
01/29/2025
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