Individual
JENNIFER REVOIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2405 WAIT AVE, WAKE FOREST, NC 27587-6805
(919) 554-0997
Mailing address
7344 CLARINCARDE CT, WAKE FOREST, NC 27587-5423
(919) 630-2893
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C003686
NC
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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