Individual
JACLYN MARIE WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
224 THERESA DR, WEIRTON, WV 26062-9637
(304) 479-9378
Mailing address
224 THERESA DR, WEIRTON, WV 26062-9637
(304) 479-9378
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
WV
Other
Enumeration date
11/18/2024
Last updated
01/27/2025
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