Individual
MRS. JENNIFER ANNE FANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3080 HENDERSON DR, JACKSONVILLE, NC 28546-5246
(910) 938-9833
(910) 938-9835
Mailing address
3080 HENDERSON DR, JACKSONVILLE, NC 28546-5246
(910) 938-9833
(910) 938-9835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6570
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103584
—
NC
Enumeration date
06/04/2007
Last updated
03/16/2011
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