Individual
DR. JACQUELYN AVERY
Active
Individual
DR. JACQUELYN AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301014810
MI
103TC0700X
Clinical Psychologist
Primary
LP5877
MN
Other
Enumeration date
10/17/2014
Last updated
06/24/2019
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