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General NPI Number Information
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NPI Number | 1306315726
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Entity Type | Individual
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Provider Name | JACQUELINE GAIL PHARR
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Gender | Female
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 635 W COLLEGE ST
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City | FLORENCE
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State | AL
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Zip | 35630-5313
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Country | US
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Telephone | 256-764-3431
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Fax | 256-765-2036
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Provider Business Mailing Address
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Address Line | 3407 SHAMROCK CT
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City | GAUTIER
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State | MS
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Zip | 39553-5337
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Country | US
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Telephone | 228-497-0690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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