Individual
JACLYN MARIE WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1011 E SONGSMITH DR, BEAR, DE 19701-1194
(302) 918-7509
Mailing address
108 GRAND CANYON CT, BEAR, DE 19701-1784
(862) 216-8434
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0011436
DE
Other
Enumeration date
09/24/2020
Last updated
07/13/2022
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