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Individual

MISS JAQULYN NIKOLE CARRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED, ATC, LAT, CKTP

Contact information

Practice address
3910 MONTLAKE BLVD NE, SEATTLE, WA 98195-0001
(317) 286-8881
Mailing address
1190 HIGHLAND LAKE WAY, BROWNSBURG, IN 46112-7833
(317) 286-8881

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A1 60486324
WA

Other

Enumeration date
07/22/2015
Last updated
07/22/2015
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