Individual
JACQUELYN PAOLA SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1545 HARBECK RD, GRANTS PASS, OR 97527-5605
(541) 476-2373
Mailing address
1215 SW G ST, GRANTS PASS, OR 97526-2544
(541) 476-2373
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C11220
OR
Other
Enumeration date
04/22/2022
Last updated
02/06/2026
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