Individual
JACQUELINE MAY VANDERBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1601 23RD AVE S, SUITE 3105 VPH, NASHVILLE, TN 37212-3133
(615) 327-7119
Mailing address
1 WYOMING ST, STE 1601, DAYTON, OH 45409-2722
(937) 208-4250
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34.014625
OH
2084P0800X
Psychiatry Physician
3499
TN
Other
Enumeration date
04/11/2015
Last updated
10/09/2020
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