Individual
JACQUELINE A NUVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4400 EASTON CMNS STE 125, COLUMBUS, OH 43219-6223
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39000625A
IN
103TC0700X
Clinical Psychologist
Primary
20042692A
IN
103TC0700X
Clinical Psychologist
39024
TX
103TC0700X
Clinical Psychologist
P.08436
OH
Other
Enumeration date
07/18/2008
Last updated
02/23/2023
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