Individual
JACQUELYN MCKAYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
(718) 584-7204
(718) 584-8394
Mailing address
2488 GRAND CONCOURSE RM 417, BRONX, NY 10458-5206
(718) 584-7204
(718) 584-8394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CASAC-27921TRAINEE
NY
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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