Veloz-Jefferson, Jackelin Jennifer

Veloz-Jefferson, Jackelin Jennifer is an individual health care provider with primary practice located at 122 W Vernon Ave , Wake Forest NC 27587-2816. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Veloz-Jefferson, Jackelin Jennifer can be contacted via phone (919) 274-4476.

Contact Information

Primary practice address
122 W Vernon Ave Wake Forest NC 27587-2816
Phone: (919) 274-4476
Fax: (919) 554-9232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2501 North Carolina

Profile Details

NPI number 1518991587
LBN Legal business name Veloz-Jefferson, Jackelin Jennifer
Credentials EDS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Apr 19th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518991587 NPPES
North Carolina MEDICAID 6107214

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