Individual
JACQUELINE KLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 ALFRED ST, BIDDEFORD, ME 04005-3102
(207) 216-2637
Mailing address
197 S WATERBORO RD, LYMAN, ME 04002-7318
(207) 604-6922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC18067
ME
Other
Enumeration date
01/12/2020
Last updated
01/12/2020
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