Individual
JACQLYNN HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA/AC
Contact information
Practice address
848 PEIRSON AVE, NEWARK, NY 14513-9762
(315) 331-2086
Mailing address
848 PEIRSON AVE, NEWARK, NY 14513-9762
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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