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General NPI Number Information
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NPI Number | 1508093964
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Entity Type | Individual
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Provider Name | MRS. JENNIFER MAYO TARTAMELLA
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Gender | Female
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 200 TAYLOR ST
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City | OXFORD
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State | NC
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Zip | 27565-2762
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Country | US
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Telephone | 919-693-3914
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Fax |
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Provider Business Mailing Address
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Address Line | 4028 CANNADYS MILL RD
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City | KITTRELL
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State | NC
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Zip | 27544-7700
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Country | US
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Telephone | 919-690-1996
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2895
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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