Individual
JILL M PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
884 WEST PARK AVENUE, PORT TOWNSEND, WA 98368
(360) 385-0321
(360) 379-5534
Mailing address
242 LEPRECHAUN LANE, PORT ANGELES, WA 98362
(360) 457-4253
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
44SC01167500
NJ
1041C0700X
Clinical Social Worker
Primary
LW00009448
WA
1041C0700X
Clinical Social Worker
PR017066
NY
Other
Enumeration date
12/12/2006
Last updated
07/12/2010
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