Doctor Name: | MRS. JACQUES N WORLDS |
NPI Number: | 1073860839 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 2092 Athens Ct Marianna, FL - 324486612 |
Business Phone Number: | 8504821177 |
Business Fax Number: | |
Mailing Address: | Po Box 5935, MARIANNA |
State: | FL |
Postal Code: | 324475935 |
Phone Number: | 8504821177 |
Fax Number: | |
NPI Enumeration Date: | 08/12/2012 |
NPI Last Update Date: | 08/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |