| NPI | 1346741709 |
|---|---|
| Former Name | JACLYN MARIE CLEVELAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008970) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 66331) |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2018-03-17 |