Individual
JACQUELINE ID-DEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 MYRON ST STE A, WEST SPRINGFIELD, MA 01089-1485
(413) 592-1980
Mailing address
888 WORCESTER ST STE 130, WELLESLEY, MA 02482-3744
(888) 964-6681
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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