Jenna Tyler Ferguson
Social Worker, Clinical in Durham, NC. Individual provider (NPI-1).
NPI number1962016204
StatusActive
Last updated in NPPESSep 3, 2020
Details
- NPI
- 1962016204
- Entity type
- Individual (NPI-1)
- Name
- Jenna Tyler Ferguson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 3, 2020
- Certification date
- Sep 3, 2020
- Last updated
- Sep 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | P012896 | NC | Yes |
Practice location
3622 Lyckan Pkwy Ste 3002Durham, NC 27707-2572
Phone 919-602-6766
Mailing address
1115 Berkeley StDurham, NC 27705-3507
Phone 704-516-4601
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