| NPI | 1235638255 |
|---|---|
| Former Name | JACQUELINE ANDREA JACQUES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 113846) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW76857) |
| 103T00000X Psychologist | |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2023-06-19 |