Individual
MS. ROSELYN ADDY JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSC,CFTS
Contact information
Practice address
982 NORTH COOPER STREET, ARLINGTON, TX 76011
(817) 597-7137
(817) 299-0394
Mailing address
982 NORTH COOPER STREET, ARLINGTON, TX 76011
(817) 597-7137
(817) 299-0394
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
TX
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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