Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 1975 | NC |
N | 103G00000X | Clinical Psychologist | 1975 | NC |
N | 103TC0700X | Clinical Psychologist | 1975 | NC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1975 | NC |
NPI | 1053518142 |
---|---|
Provider Name | Dr. Jean S Huryn |
First Address | New Bern, NC 28562-7604 |
Second Address | New Bern, NC 28560-5502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2007 |
Last Update Date | 18/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141FG | BCBS (01) | NC |
6107432 | (05) | NC |