Individual
KAREN JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-CC
Contact information
Practice address
284 MAIN ST, SUITE 390, WILTON, ME 04294-3044
(207) 645-5304
Mailing address
180 MAIN ST, WATERVILLE, ME 04901-6666
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC15927
ME
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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