Individual
RAQUEL JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13755 OLD HALLS FERRY RD, BLACK JACK, MO 63033-4129
(314) 915-3358
Mailing address
61 BROOKHILL CT, COLLINSVILLE, IL 62234-6044
(314) 915-3358
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
855544
MO
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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