Individual
JACQUELINE COTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
1038 N US HIGHWAY 377, ROCKSPRINGS, TX 78880-1522
(949) 212-8466
Mailing address
PO BOX 1036, ROCKSPRINGS, TX 78880-1036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14056
TX
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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