Provider Demographics
NPI:1730817156
Name:SAWYER, JESSICA M (PHD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:M
Last Name:SAWYER
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 1:100 GLENWAY ST STE I
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3174
Mailing Address - Country:US
Mailing Address - Phone:704-266-0546
Mailing Address - Fax:
Practice Address - Street 1:100 GLENWAY ST STE I
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3174
Practice Address - Country:US
Practice Address - Phone:704-266-0546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6152103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty