Individual
JACQUELINE G DUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3886 CALIBRE BEND LN APT 808, WINTER PARK, FL 32792-8648
(248) 342-0955
Mailing address
3886 CALIBRE BEND LN APT 808, WINTER PARK, FL 32792-8648
(248) 342-0955
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001844
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5502001844
PHYSICAL THERAPIST ASSISTANT
MI
Enumeration date
07/29/2022
Last updated
07/29/2022
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