Individual
JACKLYN MICHELLE TULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
1303 WASHINGTON ST W, CHARLESTON, WV 25302-1333
(304) 202-1699
Mailing address
31 CLAY CT, MOUNT HOPE, WV 25880-1501
(681) 463-8884
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
WV
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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