Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 2006016237 | MO |
Y | 101YM0800X | Mental Health Counselor | 2489 | AL |
NPI | 1003038514 |
---|---|
Provider Name | Ms. Jacquelyn Jay Paul-Stevens |
First Address | Hartford, AL 36362-0000 |
Second Address | Hartford, AL 36362-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |