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Individual

JACQUELYN G BLUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
212 S LINCOLN ST, LOWELL, AR 72745-9782
(479) 770-0744
Mailing address
400 N OLIVER AVE, FAYETTEVILLE, AR 72701-3931
(479) 684-6990

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
02/26/2022
Last updated
02/26/2022
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