MR. Jacque Matthew Staley
NPI #1518289008 in Fair Oaks, California
Provider Information
- NPI Number
- 1518289008
- Entity Type
- Individual
- Name
- MR. Jacque Matthew Staley
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Feb 24, 2010
- Last Updated
- Feb 24, 2010
Practice Location
- Address
- 8804 NORTH WINDING WAY
- City
- Fair Oaks
- State
- California
- ZIP Code
- 95628
- Phone
- (707) 453-6225
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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