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Individual

JALERIA NACHELLE DENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1417 N MOUNT AUBURN RD, CAPE GIRARDEAU, MO 63701-2171
(919) 288-6768
Mailing address
312 W LORIMIER PL APT B304, CAPE GIRARDEAU, MO 63701-7279
(847) 370-7554

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/22/2021
Last updated
03/22/2021
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