Individual
PATRICIA L JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTAL
Contact information
Practice address
22 SOUTH ST, VERNON, CT 06066-4553
(860) 875-0771
Mailing address
405 JONES HOLLOW RD, MARLBOROUGH, CT 06447-1038
(860) 295-0840
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
000726
CT
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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