| Doctor Name: | MS. JACQUELINE YVONNE THOMAS |
| NPI Number: | 1326465808 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BA, CADC |
| License Number: | 37CA00043100 |
| Business Practice Address: | 566 Haddon Ave. Genesis Counseling Services Collingswood, NJ - 08108 |
| Business Phone Number: | 8568589314 |
| Business Fax Number: | 8568585672 |
| Mailing Address: | 1063 Beideman Ave Apt 5, CAMDEN |
| State: | NJ |
| Postal Code: | 081054252 |
| Phone Number: | 8563651907 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2014 |
| NPI Last Update Date: | 03/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 37CA00043100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |