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General NPI Number Information
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NPI Number | 1720120785
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Entity Type | Individual
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Provider Name | JESSICA ALLYN EFIRD MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 212 LE PHILLIP CT SUITE 106
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City | CONCORD
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State | NC
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Zip | 28025-2984
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Country | US
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Telephone | 704-782-3004
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Fax | 704-782-3005
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Provider Business Mailing Address
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Address Line | 604 PEACH ST
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City | KANNAPOLIS
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State | NC
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Zip | 28083-5131
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Country | US
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Telephone | 704-502-2191
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C005129
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License Number State | NC
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