Jacquelin A Phelps

NPI #1154137552 in Roseville, Minnesota

Provider Information

NPI Number: 1154137552
Entity Type: Individual
Name: Jacquelin A Phelps
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 10, 2024
Last Updated: Dec 10, 2024

Practice Location

Address: 2812 FAIRVIEW AVE N
City: Roseville
State: Minnesota
ZIP Code: 55113-1308
Phone: (612) 345-7306

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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