Individual
BERENICE JAQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1639 N ALPINE RD STE 204, ROCKFORD, IL 61107-1481
(779) 423-0275
(815) 516-5952
Mailing address
1639 N ALPINE RD STE 204, ROCKFORD, IL 61107-1481
(779) 423-0275
(815) 516-5952
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.025870
IL
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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