Provider Demographics
NPI:1225248339
Name:MEARES, JEAN ADAMS (M ED, ITFS)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ADAMS
Last Name:MEARES
Suffix:
Gender:F
Credentials:M ED, ITFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SITTERSON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-9688
Mailing Address - Country:US
Mailing Address - Phone:919-637-5201
Mailing Address - Fax:
Practice Address - Street 1:1401 SITTERSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-9688
Practice Address - Country:US
Practice Address - Phone:919-637-5201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300157Medicaid