Individual
ALFONZO JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
210 N 6TH ST, ALLENTOWN, PA 18102-4112
(484) 221-9135
(484) 221-9130
Mailing address
2030 W TILGHMAN ST, SUITE 105B, ALLENTOWN, PA 18104-4354
(484) 221-9135
(484) 221-9130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/01/2008
Last updated
06/02/2008
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