| Doctor Name: | JACQUELINE GINGERICH |
| NPI Number: | 1114339769 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C |
| License Number: | LPC-5523 |
| Business Practice Address: | 205 107th St Orofino, ID - 835449381 |
| Business Phone Number: | 2084767483 |
| Business Fax Number: | 2084763144 |
| Mailing Address: | 13814 W 2nd Ave, OROFINO |
| State: | ID |
| Postal Code: | 835449109 |
| Phone Number: | 5097801111 |
| Fax Number: | 2084763144 |
| NPI Enumeration Date: | 05/29/2014 |
| NPI Last Update Date: | 05/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC-5523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |