Individual
JACQUELYN MAE BETANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1464 JEFFERSON ST N, LEWISBURG, WV 24901-1380
(304) 645-3220
Mailing address
152 CARDINAL WAY APT 25, LEWISBURG, WV 24901-2302
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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