Individual
JACQUELINE HASKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
975 COMMERCE DR, PERRYSBURG, OH 43551-5228
(419) 874-8257
Mailing address
975 COMMERCE DR, PERRYSBURG, OH 43551-5228
(419) 874-8257
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.1901558
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341732773
TAX IDENTIFICATION
OH
Enumeration date
02/24/2023
Last updated
02/24/2023
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