| Doctor Name: | MS. JACQUELINE WITTMAN |
| NPI Number: | 1184751711 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | LH00006443 |
| Business Practice Address: | 1020 9th St Anacortes, WA - 982214122 |
| Business Phone Number: | 3602930310 |
| Business Fax Number: | 3602930557 |
| Mailing Address: | 406 S 1st St, Suite 308 MOUNT VERNON |
| State: | WA |
| Postal Code: | 982733801 |
| Phone Number: | 3604240400 |
| Fax Number: | 3603363270 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH00006443 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |