| NPI | 1669535464 | 
|---|---|
| Former Name | JACQUELINE ANN O'CONNELL | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003411)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW - 12020)  | 
| Enumeration Date | 2006-12-19 | 
| Last Update Date | 2018-03-19 |