Individual
JACLYN SOUSA
Active
Individual
JACLYN SOUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
021648-1
NY
103TC0700X
Clinical Psychologist
10929
MA
103TC0700X
Clinical Psychologist
Primary
1657
SC
Other
Enumeration date
07/01/2016
Last updated
10/22/2021
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