Individual
JACLYN KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 JAMISON DR, CLIFTON PARK, NY 12065-7251
(518) 428-1418
Mailing address
13 JAMISON DR, CLIFTON PARK, NY 12065-7251
(518) 428-1418
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
012498-1
NY
174400000X
Specialist
012498-1
NY
Other
Enumeration date
07/26/2006
Last updated
11/16/2022
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