Individual
JACQUELYN JOANNE VANSCODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1634 SYCAMORE LINE, SANDUSKY, OH 44870-4132
(419) 626-9156
Mailing address
1634 SYCAMORE LINE, SANDUSKY, OH 44870-4132
(419) 626-9156
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
141756
OH
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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