Individual
MRS. JAQUELINE MARIA FALLON OJALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MC, LISAC, LAC
Contact information
Practice address
6015 W PEORIA AVE, GLENDALE, AZ 85302-1213
(623) 344-2861
(623) 344-4449
Mailing address
6015 W PEORIA AVE, GLENDALE, AZ 85302-1213
(623) 344-2861
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/04/2019
Last updated
06/04/2019
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