Jennette, Tadana Prayer
Jennette, Tadana Prayer is an sole proprietor health care provider with primary practice located at 620 Lynndale Ct Ste C , Greenville NC 27858-5462. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Jennette, Tadana Prayer can be contacted via phone (252) 814-5564.Contact Information
Primary practice address
620 Lynndale Ct Ste C
Greenville NC 27858-5462
Phone: (252) 814-5564
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 3567 | North Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | A12098 | North Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 12098 | North Carolina |
Profile Details
| NPI number | 1083082689 |
|---|---|
| LBN Legal business name | Jennette, Tadana Prayer |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2015 |
| Last updated | Oct 15th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083082689 | NPPES |
| North Carolina | Other | 3567 | LICENSED CLINICAL ADDICTIONS SPECIALIST |
| North Carolina | Other | 12098 | LICENSED CLINICAL ADDICTIONS SPECIALIST |
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