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General NPI Number Information
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NPI Number | 1659829372
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Entity Type | Individual
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Provider Name | BARBARA JOIE JACALA LAC AEMP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 101 DEVANT ST STE 1001
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2719
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Country | US
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Telephone | 678-310-3182
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Fax | 678-788-6690
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Provider Business Mailing Address
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Address Line | 365 MALIBU DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2586
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Country | US
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Telephone | 678-310-3182
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC60688394
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25005814
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 521
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License Number State | GA
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