Most Relevant Information
Provider Data
| NPI Number: | 1003544610 |
| Provider Name: | JESSICA ROSE WING MA, LCMHCA, NCC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | A17787 |
Most Important Dates
| Enumeration Date: | 08/11/2022 |
| Last Updated: | 08/11/2022 |
Provider Practice Location
311 WILLIAMSON RD STE 103
MOORESVILLE
NC
281175967
Practice Location Phone/Fax
| Phone: | 7043603049 |
| Fax: |
Provider Mailing Location
311 WILLIAMSON RD STE 103
MOORESVILLE
NC
281175967
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |