Individual
MRS. JACQUELINE LENORE WAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 SOLOMONS ISLAND RD N, PRINCE FREDERICK, MD 20678-3917
(410) 535-5400
Mailing address
12025 ROUSBY HALL RD, LUSBY, MD 20657-2785
(443) 404-3043
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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