Individual
MS. JACQUELYNN PATRICE PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1121 E MISSOURI AVE STE 122, PHOENIX, AZ 85014-2723
(602) 277-3535
(480) 507-5007
Mailing address
PO BOX 984, GILBERT, AZ 85299-0984
(480) 507-5004
(480) 507-5007
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
NA
AZ
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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