Individual
MR. ANDREW JOHN JAGGERNAUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
220 E 1ST AVENUE EXT STE 10, LEXINGTON, NC 27292-3375
(336) 580-1042
Mailing address
220 E 1ST AVENUE EXT STE 10, LEXINGTON, NC 27292-3375
(336) 580-1042
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8911
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922381508
—
NC
Enumeration date
09/21/2011
Last updated
04/30/2020
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