Most Relevant Information
Provider Data
| NPI Number: | 1003384082 |
| Provider Name: | JACLYN MARIE CAMPBELL |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/07/2018 |
| Last Updated: | 11/07/2018 |
Provider Practice Location
2500 PACKARD ST STE 206
ANN ARBOR
MI
481046827
Practice Location Phone/Fax
| Phone: | 2693219556 |
| Fax: |
Provider Mailing Location
526 W CENTRE AVE
PORTAGE
MI
490245306
Provider Mailing Phone/Fax
| Phone: | 2693219556 |
| Fax: |