Individual
JACQUELYN M BURNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
E0500531
OH
101YP1600X
Pastoral Counselor
E500531
OH
101YP2500X
Professional Counselor
Primary
E-0500531
OH
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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