Individual
DR. JACQUELYN A MUNIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
11264 ROUTE 37, MARION, IL 62959-8360
(618) 964-4255
(618) 997-7972
Mailing address
11264 ROUTE 37, MARION, IL 62959-8360
(618) 964-4255
(618) 997-7972
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071005891
IL
103TC0700X
Clinical Psychologist
Primary
071005891
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032028
BCBS
—
Enumeration date
09/07/2006
Last updated
03/07/2025
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