Provider Demographics
NPI:1518527886
Name:ARREZOLA, JACQUELINE (MA)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:
Last Name:ARREZOLA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1799
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-1799
Mailing Address - Country:US
Mailing Address - Phone:503-435-4840
Mailing Address - Fax:503-435-4840
Practice Address - Street 1:410 NE 3RD ST STE 2
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4624
Practice Address - Country:US
Practice Address - Phone:503-435-4840
Practice Address - Fax:503-200-1416
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor