Individual
JESSICA REYNOLDS MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 ADAMS ST, KINGSTON, NY 12401-6012
(845) 340-9170
Mailing address
59 GRAND ST, HIGHLAND, NY 12528-1209
(845) 754-4944
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
NY
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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