Provider Demographics
NPI:1073729166
Name:RALEIGH, MARY-JEANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY-JEANNE
Middle Name:
Last Name:RALEIGH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1510
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1510
Mailing Address - Country:US
Mailing Address - Phone:603-568-5250
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY DRIVE
Practice Address - Street 2:CHAVIS UNIVERSITY CENTER
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-1510
Practice Address - Country:US
Practice Address - Phone:910-521-6202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH644101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health