Individual
JACQUELINE COUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
2594 NW 152ND ST, CLIVE, IA 50325-4533
(515) 987-8155
Mailing address
2594 NW 152ND ST, CLIVE, IA 50325-4533
(515) 987-8155
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
257401
IA
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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