Individual
JACQUEISE YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1103 SUSSEX DR, FORNEY, TX 75126-6535
(219) 577-6073
Mailing address
1103 SUSSEX DR, FORNEY, TX 75126-6535
(219) 577-6073
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
02/26/2022
Last updated
02/26/2022
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