Individual
JACKIE MUSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA-R
Contact information
Practice address
1059 NW MADRAS HWY, PRINEVILLE, OR 97754-1416
(907) 378-4376
Mailing address
PO BOX 70, PRINEVILLE, OR 97754-0070
(907) 378-4376
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
08/31/2023
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