Individual
JACLYN D'ANNIBALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MORSE ST, SOUTH PORTLAND, ME 04106-2731
(860) 977-3632
Mailing address
25 MORSE ST, SOUTH PORTLAND, ME 04106-2731
(860) 977-3632
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MC15896
ME
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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