Provider Demographics
NPI:1003421645
Name:HOUDESHELL, JACQUELYN LEE
Entity Type:Individual
Prefix:MRS
First Name:JACQUELYN
Middle Name:LEE
Last Name:HOUDESHELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13486 COUNTY ROAD 216
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-8709
Mailing Address - Country:US
Mailing Address - Phone:419-957-2400
Mailing Address - Fax:
Practice Address - Street 1:13486 COUNTY ROAD 216
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-8709
Practice Address - Country:US
Practice Address - Phone:419-957-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care