Individual
JENNIFER SAMPSON IACUANIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 LOW GAP RD, UKIAH, CA 95482-3737
(707) 472-5750
Mailing address
246 MARGIE DR, WILLITS, CA 95490-4541
(916) 390-3377
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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