Individual
JACQUELYN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
604 NORTH AVE, BISMARCK, ND 58501
(701) 226-2061
Mailing address
604 NORTH AVE, BISMARCK, ND 58501-1727
(701) 226-2061
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
L37
ND
Other
Enumeration date
04/27/2018
Last updated
07/01/2019
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