IndividualActive
Jacqueline Butler, LEAD CLINICAN
NPI 1386173250 · Contractor · Philadelphia, PA
Provider details
- NPI number
- 1386173250
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Credential
- LEAD CLINICAN
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
7120 Valley Ave
Philadelphia, PA 19128-3206
Phone: (215) 508-0484
Approximate (ZIP-level) locationGet directions
Mailing address
7120 Valley Ave
Philadelphia, PA 19128-3206
Registry dates
- Enumerated
- 2017-06-05
- Last updated
- 2017-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.