Individual
JAQUELINA ANDREA REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25279 W CENTRE AVE, BUCKEYE, AZ 85326-2468
(310) 985-9501
(602) 455-4624
Mailing address
25279 W CENTRE AVE, BUCKEYE, AZ 85326-2468
(310) 985-9501
(602) 455-4624
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
2656335
AZ
385HR2055X
Child Mental Illness Respite Care
2656335
AZ
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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