Individual
JACKLINE OPIA LINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5151 AMBER VALLEY PKWY S APT 22, FARGO, ND 58104-8678
(701) 809-3320
Mailing address
5151 AMBER VALLEY PKWY S APT 22, FARGO, ND 58104-8678
(701) 809-3320
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
—
—
251E00000X
Home Health Agency
—
—
Other
Enumeration date
09/11/2023
Last updated
09/11/2023
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