Individual
MRS. JACLYN A SANTANGELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
3705 TEAYS VALLEY RD, SUITE 100, HURRICANE, WV 25526-9645
(304) 757-2500
(304) 757-2586
Mailing address
301 PLANTATION DR, HURRICANE, WV 25526-9063
(304) 757-3240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
WV001014
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062861
WORKERS COMP
WV
01
—
1714909
BLUE CROSS BLUE SHIELD
WV
01
—
311504453
CIGNA
WV
01
—
7104487
AETNA
WV
05
—
7503100-000
—
WV
Enumeration date
12/15/2006
Last updated
07/09/2007
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