Individual
JEANNINE JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5 GREENLEAF WOODS DR UNIT 201, PORTSMOUTH, NH 03801-5442
(603) 433-7596
Mailing address
5 GREENLEAF WOODS DR UNIT 201, PORTSMOUTH, NH 03801-5442
(603) 433-7596
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
384
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407744Y0NH01
ANTHEM BC/BS OF NH
NH
05
—
80002912
—
NH
Enumeration date
08/16/2006
Last updated
07/08/2007
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