Provider Demographics
NPI:1518257096
Name:PATTERSON, JAQUEL DELIA (ND)
Entity Type:Individual
Prefix:DR
First Name:JAQUEL
Middle Name:DELIA
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 EAST AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5020
Mailing Address - Country:US
Mailing Address - Phone:888-811-0112
Mailing Address - Fax:
Practice Address - Street 1:91 EAST AVE
Practice Address - Street 2:3RD FL.
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5020
Practice Address - Country:US
Practice Address - Phone:888-811-0112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000437175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath