Individual
JACLYN MICHELE DOUGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 968-6053
Mailing address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 968-6053
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
04/09/2013
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