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1194950576
JACLYN RENEE BRAZIEL
DALLAS, OR
NPI
1194950576
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Former Name
JACLYN RENEE BRANSKE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR C4153)
Enumeration Date
2009-05-28
Last Update Date
2020-02-21
Business Address
Ms. JACLYN RENEE BRAZIEL QMHP
182 SW ACADEMY ST
DALLAS, OR 97338-1996
Phone number: 503-623-9289
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Mailing Address
Ms. JACLYN RENEE BRAZIEL QMHP
2205 S CHURCH ST
DALLAS, OR 97338-9742
Phone number: 503-930-7349
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