Provider Demographics
NPI:1881075380
Name:PUZ, JACQUELINE JUNE (DMIN, LPCS)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:JUNE
Last Name:PUZ
Suffix:
Gender:F
Credentials:DMIN, LPCS
Other - Prefix:DR
Other - First Name:JACQUELINE
Other - Middle Name:GERHARDT
Other - Last Name:PUZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMIN, LPCS
Mailing Address - Street 1:3503 DENIM CT
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-9217
Mailing Address - Country:US
Mailing Address - Phone:252-670-5637
Mailing Address - Fax:
Practice Address - Street 1:3503 DENIM CT
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-9217
Practice Address - Country:US
Practice Address - Phone:252-670-5637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCS5227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional