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1154312544
SANDRA JACQUES
PORT WASHINGTON, WI
NPI
1154312544
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: WI 548123)
Enumeration Date
2005-11-03
Last Update Date
2007-07-08
Business Address
-- SANDRA JACQUES LCSW
121 W MAIN ST SUITE 350
PORT WASHINGTON, WI 53074-1813
Phone number: 262-284-8130
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Mailing Address
-- SANDRA JACQUES LCSW
PO BOX 994 SUITE 350
PORT WASHINGTON, WI 53074-0994
Phone number: 262-284-8130
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