Healthcare Provider Details

I. General information

NPI: 1851392203
Provider Name (Legal Business Name): GLORIA JEAN TEMPLETON PH.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GLORIA JEAN TEMPLETON PHD

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 03/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 JONES FERRY RD STE. J
CARRBORO NC
27510
US

IV. Provider business mailing address

PO BOX 640
CARRBORO NC
27510
US

V. Phone/Fax

Practice location:
  • Phone: 919-929-9663
  • Fax: 919-929-9663
Mailing address:
  • Phone: 919-929-9663
  • Fax: 919-929-9663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNC 1369
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1369
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: