Doctor Name: | MRS. KRISTEN MICHELLE JACQUES |
NPI Number: | 1013204767 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 217194 |
Business Practice Address: | 1563 N Main St Fall River, MA - 027202983 |
Business Phone Number: | 5086723619 |
Business Fax Number: | |
Mailing Address: | 120 Middlesex St # 3, FALL RIVER |
State: | MA |
Postal Code: | 027233723 |
Phone Number: | 5086760870 |
Fax Number: | |
NPI Enumeration Date: | 07/01/2011 |
NPI Last Update Date: | 07/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 217194 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |