Individual
MS. JOANNE JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 DALE RD, WETHERSFIELD, CT 06109-3254
(860) 768-2987
Mailing address
113 DALE RD, WETHERSFIELD, CT 06109-3254
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-22976
CT
Other
Enumeration date
03/08/2017
Last updated
03/08/2017
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