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Individual
JACQUELINE MALOCH SUDDERTH
Active
Individual
JACQUELINE MALOCH SUDDERTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSWA
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-26098
NC
1041C0700X
Clinical Social Worker
Primary
P021089
NC
Other
Enumeration date
01/14/2020
Last updated
09/20/2024
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