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General NPI Number Information
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NPI Number | 1275940561
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Entity Type | Individual
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Provider Name | JENNIFER SHANNON FILCOFF PH.D.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 2500 REGENCY PKWY
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City | CARY
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State | NC
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Zip | 27518-8549
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Country | US
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Telephone | 919-654-3004
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 REGENCY PKWY
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City | CARY
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State | NC
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Zip | 27518-8549
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Country | US
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Telephone | 919-654-3004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY3805
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 103TE1100X
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Taxonomy Name | Exercise & Sports Psychologist
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License Number | PSY3805
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License Number State | CO
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