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General NPI Number Information
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NPI Number | 1811277411
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Entity Type | Organization
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Legal Business Name | JACQUELYN HARTMAN, LPC, PLLC
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 815 N ARENDELL AVE
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City | ZEBULON
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State | NC
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Zip | 27597-2305
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Country | US
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Telephone | 919-602-5797
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Fax | 919-269-7761
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Provider Business Mailing Address
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Address Line | PO BOX 116
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City | ZEBULON
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State | NC
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Zip | 27597-0116
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Country | US
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Telephone | 919-602-5797
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Fax | 919-269-7761
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Authorized Official
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Title or Position | ART AND PLAY THERAPIST
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Name | MRS. JACQUELYN RENEE HARTMAN
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Credential | M.S., LPC
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Telephone | 919-602-5797
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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 | 8527
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License Number State | NC
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