Individual
JACQUELINE ANN CISTERNINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 724-6185
Mailing address
24230 KARIM BLVD, NOVI, MI 48375-2960
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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