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Individual

JACQUELINE WATKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SOCIAL WORK LMSW

Contact information

Practice address
1341 BERTRAM ST, CEDAR RAPIDS, IA 52403-9001
(319) 866-6000
Mailing address
1341 BERTRAM ST, BERTRAM, IA 52403-9001
(319) 866-6000

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
086466
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086466
IA
Enumeration date
12/13/2017
Last updated
12/13/2017
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