Individual
JACLYN VON DER HEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
4700 S RIDGE RD APT 419, MCKINNEY, TX 75070
(817) 673-8169
Mailing address
4700 S RIDGE RD APT 419, MCKINNEY, TX 75070
(817) 673-8169
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
2000022804
TX
174H00000X
Health Educator
Primary
AT6520
TX
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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