Individual
DOROTHY K SOQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
124 DAGGETT AVE, VINEYARD HAVEN, MA 02568-6406
(508) 693-5418
Mailing address
124 DAGGETT AVE, VINEYARD HAVEN, MA 02568-6406
(508) 693-5418
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106899
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO4429
BC/BS
MA
Enumeration date
01/30/2009
Last updated
01/30/2009
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